Possible exposure - mucous membrane?

[littleumbrella]

Hi Doctor,

Recently, I’ve learned HIV and hepatitis could be transmitted through mucous membrane such as the inside of the nose. I also know HIV and C hepatitis can’t be transmitted through respiratory secretions or saliva, but I’ve read that it could be of concern if there was blood mixed in them.

I tell you this because I’m concerned about something that happened to me yesterday. While visiting a friend who is hospitalized in the intensive care unit, another patient in the room asked me something and when I approached him, he coughed in my face and I received some inside my nose. I wasn’t worried at the moment (just disgusted!) and soon afterwards I took some brown paper to wipe it off. I only realized later that there could have been blood mixed in his cough and I had not looked at what I had wiped off my face.

Now, I know spitting/coughing blood isn’t a common occurrence, but this guy had a tube going inside his nose to get fed I think and I remember he had some blood on the side of his nose alongside the tube. I also remember that last week he had a tube going through his neck to breath. I fear those things could have made him cough blood.

Do you think I should get tested? And if so, which tests should I get and when?
I think what happened to me is very low risk, but I’m still worried and I’d like to get your opinion.

Thank you for your answer.

[littleumbrella]

Thanks a lot for your answer and your patience in dealing with anxious people such as me!

[Edward W Hook, MD]

Please re-read my answer. HIV has never been spread by aerosol.  Never means never.  If it had been I would know it.  This was not a risky exposure, even if blood was present.  EWH

[littleumbrella]

Thank you for your fast answer Doctor Hook.

I'd just like a precision, if it isn't too much to ask. I had already deduced that regular cough wouldn't infect and your answer confirms it. However, I don't understand with your answer if the same is true when someone is coughing blood or if there is blood in his cough/spit/aerosol.
This possible blood still worries me because I definitely felt a few large droplets get inside my nose. If those large droplets were bloody, am I still not at risk?

Thank you very much.

[Edward W Hook, MD]

Welcome to the Forum.  I agree with you, it is rather disgusting to have people (anyone) cough in your face.  While it is disgusting however there is no risk of HIV from the aerosol exposure you experienced.  Even if he was somehow infected with HIV or hepatitis, these infections have never been transmitted by cough/aerosol. This has been thoroughly studied since doctors (particularly anesthesiologists) are often exposed to these sorts of aerosols and there is no evidence that anyone has ever been infected by a cough or that it is even possible.  You are, of course, at risk for getting a cold or the flu that way however.
I certainly wouldn’t worry about HIV or hepatitis from this rather unpleasant experience.  There is no need for concern or for testing.  EWH