Envelope Viruses

[AD1358]

I have OCD related to fear of contagion. I was diagnosed with OCD earlier this year and my fear was of contracting diseases like HIV from through non conventional routes. I am glad to inform you that I am over the fear of HIV and am not obsessing about it anymore at all. The post written by NurseGirl on HIV have been extremely helpful.

I however still have some fear of other viruses like Hep C which I am told can survive in the environment for sometime (hours to days). I have noticed that medication and education have helped me in overcoming my obsessions and though I am a lot more calm (not anxious now) I still have some questions

My understanding is that Hep C virus has a lipid envelope just like HIV. According to Nursegirl the outer shell of HIV (I assume this is the lipid envelope) starts to get destroyed when the virus or the fluids containing the virus get exposed to the environment. The outer shell or the lipid envelope is sensitive to temperatures, moisture, ph levels, UV rays and what not. My question is ....is it correct the assume that Hep C virus would have the same problem of being transmitted from the environment ? I mean Hep C has a lipid envelope as well and so can we assume that hep C in a bit of blood left on door knobs and other in animated objects is technically infectious (not dead) but the envelope is already started to get destroyed so it can't attach to the host cells and replicate ?

I guess most experiments done by researchers for Hep C or any other viruses are in controlled environments and so can we assume that in the real world we need not worry about hardy viruses like Hep C lurking around somewhere ?  

[mariabianca]

Hi - Yes, I would agree with this after much counseling. I have OCD & OCD HIV. A few weeks ago I was off my meds due to a medical issue. I met a potential new boyfriend & went into a full fledged panic attack over a foreplay & ejaculation issue. He ejaculated on my hand (that one seemed ok - no cuts that I could SEE). I was convinced I had HIV because I had a small cut & scrape on my other hand that touched the clean up towel. Keep in mind he told me he was clean but my OCD said nope, he MUST have HIV. I was counseled by HIV experts & told no risk because the virus loses its infectiousness upon hitting the air & it has NOTHING to latch on to, it NEEDS the mucous membranes which your hands DON'T have. It was only after reading a post by nursegirl6572, seeing my doctor, having my blood work done (all ok) & getting on the Effexor that I'm almost back to normal.

[AD1358]

Had a few links to share

http://www.hepatitiswa.com.au/about-hepatitis/hepatitis-c.html

"Hepatitis C cannot infect a person if their skin and mucous membranes are intact. Intact healthy skin is a protective barrier against harmful micro-organisms such as bacteria and viruses; making the skin, which is the largest organ of the body, a crucial part of the immune system."


http://www.serc.mb.ca/sexual-health/stis-and-hiv/hepatitis-c

"Hepatitis C spreads when infected blood, semen or vaginal fluid gets into your blood, through a break in your skin or mucosa (thin, moist lining) inside the mouth, vagina or rectum."

http://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/health+topics/health+conditions+prevention+and+treatment/infectious+diseases/hepatitis/hepatitis+c

"Hepatitis C is spread by blood-to-blood contact through needle puncture, broken skin or a break in mucous membranes"

http://www.health.gov.on.ca/en/pro/programs/hepatitis/docs/hepc_assess_e.pdf

"Hepatitis C is spread mainly by parenteral exposure to an
infected source, although transmission can occur in
settings where blood-to-blood contact is not apparent.
Hepatitis C is not spread through intact skin or mucous
membranes, aerosol or droplet spread, or the fecal-oral
route"

http://www.smashfit4kids.com/component/k2/content/150-hepatitis-c

"Hepatitis C is spread by direct contact with infected blood or body fluids. This occurs, when there is a needle puncture, broken skin or a break in the mucous membrane (National Health and Medical Research Council, 2012, p116)"

I think all these link precisely state that Hep C is transmitted via break in mucous membrane and not via intact mucous membrane. If this is true then I guess we should not be worried about hep C via eyes, nose, mouth or any other mucous membrane. Any thought ?

[Trippintothemax13]

Man you sound just like me! I freak out over everything expesially since my friend got hep. C and was living with us when she found out!! I was very scared and got tested. Still going to get tested. So far has been fine. The other day I forgot to wash my hands and was licking my fingers and everything. Before that I had been mopping with a mop used in bathrooms and they still have there nasty gloves on when they mop. I am freaking out bout if I got anything by this. I know I had a cut on my lip too cause when I ate the lemon it burned. after reading all these post I feel MUCH MUCH better.

[sparky43]

You are correct that having blood splashed in your eyes is a low risk event.  Your mucous membranes are more delicate than normal skin, but they are still a barrier.  There are no studies on blood splashes and hep c, but the chances of infection from having blood splashed in your eyes are probably less than from a needle stick.   And unless you are performing surgery or are in a combat situation, the chances of having blood splashed into your eyes is miniscule.

On a side note, the mouth is designed to heal more quickly than other parts of your body.  Because that is where food (which is sometimes hard and pointy) goes, evolution has equipped us with an enzyme which makes cuts in the mouth seal and heal very quickly.  If hepatitis were to get in your mouth, any amount that was swallowed would be quickly killed by stomach acid.

If there is any advice I can give you, one is to have more faith in your immune system.  It is a remarkable thing and keeps us alive, even if we are exposed to "germs".   The other is to work on accepting uncertainty.  I think that is at the route of OCD.  We try to eliminate uncertainty from our lives and are constantly trying to find more information and reassurance that everything is ok.  Nothing is certain in life, but if you can accept that being infected by hep c is possible but highly improbable, you will be much happier and anxiety free (at least most of the time).

[AD1358]

Thanks for taking the time to reply back to my concerns.

I agree with you on all counts. The only other concern that I have is about rubbing my eyes with hep C infected blood. It sounds stupid I know. However, I have been able to come up with the following so far

1. If I was to put some blood from my fingers into my eye it would most probably sting to an extent that I would have leave everything and wash my eye

2. No matter how much blood I have on my finger I need to remember that I when I rub my eye my eye lid closes and so very little amount of blood can get in my eye

3. even if I was to be rubbing a picking out some dirt near my eye lashes (with my eye lids are open) I still cannot get enough blood into my eye as I would always be careful not to touch the white portion of my eye.

4. All the cases of infection occurring via the eye has been in health care settings when large amount of blood was splashed in the eyes of a medical professional and even then it chances were low that infection would occur. I can simply never have that much blood get into my eye in regular life.

5. Of all the helplines I have called to get information about Hep C all of them have told me that you can't get hep C by rubbing blood in your eyes. Not one of them ever mentioned how much blood or how much did you rub or anything else.

I guess I have to just come on terms with the fact that while exposed mucous membranes like eyes, mouth, nose can lead to bloodstream they are extremely hard routes to get infected.    

[sparky43]

I have had worries about the same thing.  You are correct that HIV doesn't survive very long outside of the human body. It basically dies once it is exposed to air.  It is definitely dead if the fluid it was in has dried.

Hepatitis B and C are tougher viruses - I'm not exactly sure why.  They may have thicker more durable envelopes, but that's just a guess.  There is one study that showed Hepatitis C can stay alive up to 4 days, even if it is in dried blood (Hep C is only transmitted by blood to blood contact).  Hepatitis B can survive up to 7 days in the environment and is found in blood, semen and vaginal fluids (which is why Hep B is classified as a sexually transmitted disease while Hep C is not).

However, you need to remember that if there is Hepatitis on an environmental surface, they all do not stay alive for four days and then suddenly die all at once.  Some will die immediately and others will survive longer.  By the beginning of the fourth day, there are very few viruses still alive.  The rate at which they die is effected by the factors you mentioned in your post.   One study showed that the amount of alive Hepatitis C virus is reduced by tenfold after a day.  Another interesting study found that the virus dies much more quickly on copper surfaces, but scientists don't know exactly why.  The metal appears to have some anti-viral properties.

So, to answer your question, Hepatitis is not something to worry about on surfaces, but not for the reason you proposed (that it dies off quickly like HIV).  There are many reasons not to fear coming in contact with environmental surfaces.  The first is that human skin is an excellent barrier to the Hepatitis virus.  It cannot penetrate intact human skin.  If you were to get Hepatitis virus on your intact skin, it would just sit there until it died or was washed / rubbed off.

Even on broken skin, it is still not easy to become infected.  Cuts and scratches seal up quite quickly (within minutes) and do not allow viruses through, even if the wound looks open (breaks in the skin start healing from the inside out).  Hepatitis C needs to get fairly deep into the skin (ie reach the bloodstream) in order to cause an infection.  To get infected, Hepatitis C would have to come in contact with an open gaping bleeding wound, and even then it's not a done deal.  The virus would have to make it past your immune system to your liver before it could start replicating and cause an infection.  It takes a while for your body to develop antibodies, but other parts of your immune system attack viruses as soon as they enter the body.

There is actually confirmed imperical data that demonstrates the likelihood of infection by viruses.  Medical personnel who have been accidentally stuck by a needle or cut by a scalpel that has the blood of a patient known to be infected with a virus get infected at the following rates:
Hepatitis B: 30%
Hepatitis C: 3%
HIV: 0.3%

So, as you can see, it is rather hard to be infected by HIV (which you already knew).  Hepatitis C is more infectous, but still hard to get.  Hepatitis B is the most infectious of the three, but 90 to 95% of people who become infected with Hep B naturally clear the virus from their body and are immune from that point forward.  On top of that, there is an effective vaccine for Hepatitis B which you might want to get if you have not already.

So that leaves Hep C.  Becoming infected by it from an environmental surface is theoretically possible, but highly unlikely.  Only 2% of the American public are infected with Hepatitis C and most of those people don't walk around leaving their blood on doorknobs, so there is not much of the virus outside of people's bodies.  On top of that, even if you were incredibly unlucky to have some of the virus reach your bloodstream and cause as an infection, there have been some dramatic advances in the development of a cure.  There are currently 6 drug companies who are working on it and two of them may be available as soon as 2014.

So, while viruses are a cause for concern, they are in the same way as plane crashes, lightning strikes and muggings.   You need to differentiate between  possibility and probability.  I would recommend not using IV drugs, not having unprotected sex with multiple partners, not having a medical procedure performed in a third world country, getting a tattoo unless you are absolutely sure the "artist" follows strict sterilization procedures, or sharing items that may have someone else's blood on them (toothbrushes, razors, nail clippers) and you will be fine.

[AD1358]

Your comments would be appreciated