STD Transmission possibility ...

[AllisonR.]

Hello and thank you ahead of time for answering my question. First the story: I went to a new OBGYN for my yearly Pap test. I am married, monogamous and have never had an STD. The new OBGYN came in and did the breast exam and then told me to lie back for the Pap test. He grabbed a pair of gloves and did the Pap and then a pelvic exam. He also called in a nurse to assist and be in the room during the exam. She grabbed a pair of gloves too. I was nervous because it was my first time seeing this OBGYN and was bothered by the fact that he did not wash his hands when he came in before examining me, and neither did the nurse. They both just grabbed gloves (wouldn't this contaminate the outside of the gloves?) and then removed the gloves after the exam - no hand washing before or after. When he was done he removed the gloves and left without washing his hands. Now this has me thinking that he probably does this (no handwashing thing) with all of his patients ... including the ones before me! And now I am worrying more each day about what could have been on his hands and the nurse's hands when they grabbed (and contaminted?) those gloves!

Now my questions:
(#1) What are the chances of me getting any kind of STD from this OBGYN not washing his hands before the exam? I have read many places online that some STDs can be transmitted by secretions on fingers, and to the eyes from fingers/hands too. If he did not wash his hands after his last the patient (and he didn't wash his hands after me, so it's quite probable), and IF his last patient had an STD, then his hands could have been contaminated with any kind of secretions or who knows what from the patient before me. Then when he came into my room and grabbed the OUTSIDE of the gloves and then inserted those same gloves into me for the manual pelvic exam ... could this transmit an infection to me?
  (#2)Also, I'm worried because I have 4 children who use the same bathroom as us and about the spread of secretions on bathroom surfaces. Also, my children have gotten bacterial pinkeye 3 times over the last 3 months, and I am starting to worry that maybe they are picking up chlamydia or something in our bathroom and then rubbing their eyes and getting repeated infections. I read that chlamydia and gonorrhea can infect the eyes from hand contact with secretions.

So now I am very worried that I picked up an STD at the doctor's office and further worried that if I did I could be passing it via secretions to my children. Like I said, I have never had an STD and the thought of getting one scares me. From now on I am going to ask my OBGYN to wash his hands before he grabs the gloves or otherwise touches me. Is it common for OBGYNs to not wash their hands first or after? Seems very risky to me. How long can those STDs live on hands as secretions and be passed to others that way? Seconds? Minutes? Long enough to go from one room to the next on warm 98.6 degree human hands?

Thanks again!


:)

[tktktk]

so u can't really get stds on the hand from touching the genitals? i understand that you can't really spread from touching genital to hand then to another genital but can u get the infection on the hand? not much online help, all they say is infections are passed from skin to skin contact.

[H. Hunter Handsfield, M.D.]

In 30+ years in a busy STD clinic, I have seen exactly 1 chlamydial eye infection and 1 case of gonorrhea of the eye.  Hand-to-genital STD transmission is extremely rare even in the context of intimate sex (i.e., from a partner's genitals) or auto-inoculation from one's own infection.  It has never been known to occur in a doctor's office.  You are barking up a tree without a cat in it.

HHH, MD

[sparkeler]

They are called std's because you have to have sex to get one.  Hand to genitals to dont transmit std's, nor does sharing toilet seats.  I agree with Englishmen, it's nothing more then poor hygene on your ob/gyn's part.  Switch doctors.

[AllisonR.]

But I read that some STDs could be spread by secretions on fingers. Like how people get chlamydial and gonorrheal eye infections when they touch their eyes with contaminated fingers.

[Englishman]

Sounds unlikely to pass on an STD to me - but does indicate bad practice as far as I am aware.

MRSA (not an STD) is a problem here in the UK and is thought to be the result of poor staff hygiene (hand-washing technique) and unclean wards.

[AllisonR.]

Thank you Dr. HHH!

It's a relief to hear that. We hear so much nowadays about sreading infections and contamination, like with the e-coli in the spinach, and then the lettuce, and with MRSA in the hospitals and now in the general public, and HIV, SARS, Bird Flu and everything else. It tends to make a person worry about what can and cannot be picked up in different settings.

If all I have to worry about is my sexual activity then I'm okay. I don't plan on sleeping with anyone else other than my husband for the rest of my life.

But it is easy to worry in the world we live in nowadays.

Oh yeah, and I am definitely going to find a new OBGYN. We just moved to a new town, so I am sure I can find a new doctor that will be more careful with handwashing. Next time I am going to insist! No more worrying for me ... I can't take the stress! :O


Thank you everyone for your responses too!

Hope everyone has a great Christmas and New Year! :)


.

[Englishman]

MRSA is an increasingly significant risk (but still rare) and not a risk from the exposure you had. If governments had a "war on MRSA" instead of "war on Terror", they would save hundreds of times more lives with less money!

The image of a SWAT team bursting into a dirty hospital armed with a mop and bucket seems to be a no-goer for some reason...

[peekawho]

We have sanitizing hand gel outside of each room.  We use it prior to entering the room, and again when we leave.

[H. Hunter Handsfield, M.D.]

It's hard for me to comment about whether or not the doctor and nurse used adequate or inadequate infection control, gloving, etc; too much opporunity for mis-interpretation.  For example, perhaps they washed their hands immediately before coming in the room.

But even if there was a problem, it doesn't imply STD risk.  Conceivably there might be risk from other bacteria like staph or strep, but even those are low risk either for contamination or for ill effects even if there were contamination.  But there has never been a reported case of any STD transmitted by poor health provider technique in the way that you are worried about, at least not in the past 50 years.

Finally, STDs are not transmitted in the home, to children or anyone else, except by sex.  (That's why they're called sexually transmitted diseases, of course.)

Bottom line:  Don't worry about STDs unless your sexual behavior (or a pertner's behavior) puts you at risk.

Good luck--  HHH, MD