Aa
WORRIED AND STRESSED OUT!
I am a dentist, and was seeing a HEP C positive patient… I took all the precautions and did not have a needle stick…. i was wearing safety goggles, but as i was fixing my patients provisional acrylic tooth, I felt a little something in my eye… and I dunno if it was my own serum as it was a very EARLY morning patient, or if a little small piece of acrylic went through the spaces below my goggles and landed on my eye… I know it was not blood to blood contact… but ive been so anxious ever since…. and I have felt weird but I think it might be the stress, I am moving to spain to study my postgrad specialty, and many other stresful situations around me, my physician put me under clonazepam drops.… do you think i have a chance of getting HCV or am I just being paranoic?.. even if the acrylic had landed in my eye… Ps. the provisory had previously been rinsed with Bleach, before I started fixing it…
This discussion is related to Am I at risk for Hep C?.
This discussion is related to Am I at risk for Hep C?.
Transmission of hepatitis C by blood splash into conjunctiva in a nurse.
Hosoglu S, Celen MK, Akalin S, Geyik MF, Soyoral Y, Kara IH.
Department of Infectious Diseases and Clinical Microbiology, Dicle University Hospital, Diyarbakir, Turkey.
The risk of transmission of hepatitis C virus (HCV) infection is an important problem for the health care worker. HCV transmission by blood splashing into eyes is very rare. In a hemodialyses department, a 23-year-old female nurse splashed blood from a patient who was anti-HCV positive into her eyes. She washed her eyes with water immediately and reported to the infection control department. She had never used intravenous drugs nor received transfusions. At the time of exposure, there was no abnormality in her laboratory tests. Her anti-HCV and HCV-RNA tests produced negative results. She was followed up for anti-HCV and alanine aminotransferase activity. After 6 months, she presented with sore throat, nausea, vomiting, fatigue, and weight loss. She had icterus and hepatomegalia. In laboratory tests, alanine aminotransferase level was 504 U/L, aspartate aminotransferase level was 388 U/L, and anti-HCV and HCV-RNA tests produced positive findings. She was treated with interferon alfa-2a for a 1-year period. After treatment, an HCV-RNA test produced negative results and transaminase levels were normal. In conclusion, splashing blood from patients who are HCV positive into the face or eyes is a risk for health care workers. They should be educated to prevent a nosocomial acquisition of bloodborne infection and they should observe protective precautions.
Hosoglu S, Celen MK, Akalin S, Geyik MF, Soyoral Y, Kara IH.
Department of Infectious Diseases and Clinical Microbiology, Dicle University Hospital, Diyarbakir, Turkey.
The risk of transmission of hepatitis C virus (HCV) infection is an important problem for the health care worker. HCV transmission by blood splashing into eyes is very rare. In a hemodialyses department, a 23-year-old female nurse splashed blood from a patient who was anti-HCV positive into her eyes. She washed her eyes with water immediately and reported to the infection control department. She had never used intravenous drugs nor received transfusions. At the time of exposure, there was no abnormality in her laboratory tests. Her anti-HCV and HCV-RNA tests produced negative results. She was followed up for anti-HCV and alanine aminotransferase activity. After 6 months, she presented with sore throat, nausea, vomiting, fatigue, and weight loss. She had icterus and hepatomegalia. In laboratory tests, alanine aminotransferase level was 504 U/L, aspartate aminotransferase level was 388 U/L, and anti-HCV and HCV-RNA tests produced positive findings. She was treated with interferon alfa-2a for a 1-year period. After treatment, an HCV-RNA test produced negative results and transaminase levels were normal. In conclusion, splashing blood from patients who are HCV positive into the face or eyes is a risk for health care workers. They should be educated to prevent a nosocomial acquisition of bloodborne infection and they should observe protective precautions.
thank you all for your comments. You know, as a dentist, we do get tought the wasy of transmission, and the stats, but it isnt until you come up with a chance that you start looking for little gaps to those statistics you know. I dont practice in the states, I live in Sao Paolo Brazil, people here NEVER tell you they have a blood borne desease.... this was a first, and me being just graduated from dental school ( 2 years ago) Believe me it kind of shakes you, I think it is the fact that i am moving, and that Ive been looking foward to this since, i was a 2nd year dental student.... I am freaked out that womething would stop it.... I am sorry guys, I know, that Im being paranoic, but you know it always helps to hear someone tell you, you will be alright... thanks
HCV since 1972 (a present from the US Army during inoculations using air guns). Have made love to my wife for 30 years, we have two kids that are grown. Each have been tested several times, always negative results. Lots of saliva and other bodily secretions have been exchanged over those year with my wife. She tests negative for Hep C and anything else over and over again. Don't worry, be happy.
Although quite rare there have been cases of transmission from a patient to a medical provider through a blood splash into the eye. A study was done at NIH a few years ago and they were able to document 2 cases of transmission that way. You probably are fine, but to put your mind at ease you should be tested as soon as possible for a baseline and then 3-6 months later.
No, let me. Keep in mind I had periodontal surgery two weeks ago and haven't been to brush my teeth yet! That will give him cause for concern. ;)
you cant have an opinon on this forum , if you do your posts get deleted, how sad is that
Although I can't be sure, I believe I contracted HCV during oral surgery. The timing is about right, and I had no other known risks.
Its not just dentists who dont know the facts on hepatitis,most of the people on the planet havnt a damn clue.
I do agree though a doctor of any sort that has contact with a patient should know how the most infectious diseases in the world are spread....especially when we've read so many cases of dentists infecting numerous patients on more than one occasion.
Can Saliva Transmit Hepatitis C?
March 8, 2007
Printer-friendly version
With over 5 million Americans infected, the Hepatitis C virus is the most common cause of liver disease today. Although it is believed to be primarily transmitted through blood to blood contact, there are indications that other means of contracting Hepatitis C are possible. Of primary interest to those concerned with the number one cause of liver disease is the possibility of transmitting Hepatitis C via saliva.
by Nicole Cutler, L.Ac.
As the most common chronic blood borne infection in the United States, the concentration of Hepatitis C virus in a drop of infected blood is exponentially higher than the concentration of HIV in a drop of infected blood. This explains why it is important to avoid anything that could possibly be tainted with any amount of blood. While not normally found in urine, semen, vaginal/cervical fluids, feces or saliva, injury or illness may cause some of these substances to be contaminated with blood.
In nearly half the cases of Hepatitis C, the infected individuals cannot identify the source for their infection. While it is believed most cases are due to risk factors involving contaminated blood, there remain unidentified modes of Hepatitis C transmission. Salivary transmission is one potential explanation for many unexplained viral causes.
Tiny and Infectious
Measuring only about 50 nanometers in diameter, Hepatitis C is an extremely small virus. A nanometer is one billionth of a meter; 200,000 Hepatitis C viruses placed end to end would only measure a single centimeter. Smaller than the wavelength of visible light, viral particles have no color. In those who are infected, Hepatitis C may produce approximately one trillion new viral particles every day.
Unlike many other viruses (like HIV), any potential source of blood to blood contact seems capable of carrying the Hepatitis C virus. This is true, even if the source is indirect, such as a used razor, making HCV far more transmissible than most other blood borne viruses. As documented by occupational exposure statistics, Hepatitis C is approximately seven times more infectious than HIV.
Saliva
People with chronic Hepatitis C are advised not to share toothbrushes, razors, nail clippers or other personal articles that may have potentially been in contact with their blood. While there is very little emphasis on saliva as a vehicle of Hepatitis C transmission, under the right circumstances there is some evidence to the contrary:
1. As published in the September 2006 issue of Journal of Viral Hepatitis, German researchers investigated the transmission of Hepatitis C via a toothbrush. A team from the University of Regensburg examined 30 patients with Hepatitis C to see whether they had contaminated their toothbrushes with the virus. They collected saliva samples from infected patients both before and after tooth brushing. Figures showed that 30 percent of infected patients tested positive for traces of the virus in their saliva before brushing their teeth, while 38 percent tested positive in their saliva after brushing. Additionally, about 40 percent of the water used to rinse the infected toothbrushes tested positive for the virus. This information confirms the caution against toothbrush sharing, and also sounds a possible Hepatitis C transitory alarm.
2. In September of 2003, evidence that saliva contains the Hepatitis C virus was disclosed at the Interscience Conference on Antimicrobial Agents and Chemotherapy. Scientists from the University of Washington in Seattle concluded that while saliva may be infectious, the strongest predictor of viral presence in the saliva is serum viral load. Researchers found that Hepatitis C was not found in saliva if the person’s viral load was under one million. Additionally, any risk of acquiring infection through salivary contact existed only in the presence of gum disease. Investigators attribute this risk to microscopic amounts of blood in the saliva and visually undetectable open mouth wounds present in gum disease.
All possibilities must be considered in trying to determine how unknown sources of Hepatitis C infection took place. Although Hepatitis C has been detected in saliva, the necessary conditions render it unlikey—but not impossible—to be transmitted by kissing or through the sharing of a toothbrush. Before anybody panics about these potential risks, remember that there are conditions accompanying these possible modes of transmission:
· The person with the virus must have a viral load over one million.
· Both parties involved have gum disease.
While experts view the risk of transmitting this disease through saliva as extremely low, it is recommended to maintain good oral hygiene, and toothbrushes be used solely by their owners.
March 8, 2007
Printer-friendly version
With over 5 million Americans infected, the Hepatitis C virus is the most common cause of liver disease today. Although it is believed to be primarily transmitted through blood to blood contact, there are indications that other means of contracting Hepatitis C are possible. Of primary interest to those concerned with the number one cause of liver disease is the possibility of transmitting Hepatitis C via saliva.
by Nicole Cutler, L.Ac.
As the most common chronic blood borne infection in the United States, the concentration of Hepatitis C virus in a drop of infected blood is exponentially higher than the concentration of HIV in a drop of infected blood. This explains why it is important to avoid anything that could possibly be tainted with any amount of blood. While not normally found in urine, semen, vaginal/cervical fluids, feces or saliva, injury or illness may cause some of these substances to be contaminated with blood.
In nearly half the cases of Hepatitis C, the infected individuals cannot identify the source for their infection. While it is believed most cases are due to risk factors involving contaminated blood, there remain unidentified modes of Hepatitis C transmission. Salivary transmission is one potential explanation for many unexplained viral causes.
Tiny and Infectious
Measuring only about 50 nanometers in diameter, Hepatitis C is an extremely small virus. A nanometer is one billionth of a meter; 200,000 Hepatitis C viruses placed end to end would only measure a single centimeter. Smaller than the wavelength of visible light, viral particles have no color. In those who are infected, Hepatitis C may produce approximately one trillion new viral particles every day.
Unlike many other viruses (like HIV), any potential source of blood to blood contact seems capable of carrying the Hepatitis C virus. This is true, even if the source is indirect, such as a used razor, making HCV far more transmissible than most other blood borne viruses. As documented by occupational exposure statistics, Hepatitis C is approximately seven times more infectious than HIV.
Saliva
People with chronic Hepatitis C are advised not to share toothbrushes, razors, nail clippers or other personal articles that may have potentially been in contact with their blood. While there is very little emphasis on saliva as a vehicle of Hepatitis C transmission, under the right circumstances there is some evidence to the contrary:
1. As published in the September 2006 issue of Journal of Viral Hepatitis, German researchers investigated the transmission of Hepatitis C via a toothbrush. A team from the University of Regensburg examined 30 patients with Hepatitis C to see whether they had contaminated their toothbrushes with the virus. They collected saliva samples from infected patients both before and after tooth brushing. Figures showed that 30 percent of infected patients tested positive for traces of the virus in their saliva before brushing their teeth, while 38 percent tested positive in their saliva after brushing. Additionally, about 40 percent of the water used to rinse the infected toothbrushes tested positive for the virus. This information confirms the caution against toothbrush sharing, and also sounds a possible Hepatitis C transitory alarm.
2. In September of 2003, evidence that saliva contains the Hepatitis C virus was disclosed at the Interscience Conference on Antimicrobial Agents and Chemotherapy. Scientists from the University of Washington in Seattle concluded that while saliva may be infectious, the strongest predictor of viral presence in the saliva is serum viral load. Researchers found that Hepatitis C was not found in saliva if the person’s viral load was under one million. Additionally, any risk of acquiring infection through salivary contact existed only in the presence of gum disease. Investigators attribute this risk to microscopic amounts of blood in the saliva and visually undetectable open mouth wounds present in gum disease.
All possibilities must be considered in trying to determine how unknown sources of Hepatitis C infection took place. Although Hepatitis C has been detected in saliva, the necessary conditions render it unlikey—but not impossible—to be transmitted by kissing or through the sharing of a toothbrush. Before anybody panics about these potential risks, remember that there are conditions accompanying these possible modes of transmission:
· The person with the virus must have a viral load over one million.
· Both parties involved have gum disease.
While experts view the risk of transmitting this disease through saliva as extremely low, it is recommended to maintain good oral hygiene, and toothbrushes be used solely by their owners.
Blood to blood is the key,and the way you describe what happened ,you did not contract hep C.But you will need to get tested in afew weeks to ease your tension,im not sure of the time it takes for the antibodies to show up on the blood tests,but odds are very much in your favour you are ok.
No risk there, so try not to worry.
Spain is a wonderful place - you will love it.
jd
Spain is a wonderful place - you will love it.
jd
I'm very surprised that as a dentist you don't know this answer. It actually scares me that a dentist has to ask this question!
Isn't this covered in class? You would think they would at least make dentists aware of transmission methods. The wonder why so many people get HCV from their dentists, it is because they know nothing about it !!
Once again it comes down to the goverment needing to educate the public.
PS, you don't need to worry. from what you describe you had no risk. even if it was blood in your eye you would still not be at risk.
Isn't this covered in class? You would think they would at least make dentists aware of transmission methods. The wonder why so many people get HCV from their dentists, it is because they know nothing about it !!
Once again it comes down to the goverment needing to educate the public.
PS, you don't need to worry. from what you describe you had no risk. even if it was blood in your eye you would still not be at risk.
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First, it is fine to have concerns. You are trying to get up to speed on things that could affect you or your technicians, and so you are to be congratulated. Anyone who thinks that you know it all when you graduate is naive. Further, information is dynamic. What we "know" may change from year to year.
Next, addressing a post about saliva, there is very very often blood as well and once should always assume there is blood in the saliva. One should basically assume that anyone you work on has some blood borne communicable bug, not just the ones who inform you. By the way, from what I read only about 1/3rd to 1/2 of us HCV infected have been diagnosed. I'm sure that you have worked on others who were infected that did not know it.
By the way, my doctor does not wear goggles either. I don't think it a bad idea. I have never heard of a confirmed case of HCV transmission via blood or saliva in the eye. I'm not saying it can't happen but I don't think you'd find much by searching the "net".
My feeling is that if you are freaked out about it go get a check for antibodies in a few weeks (4-6 weeks). It never hurts to have a baseline. Incidentally, I believe this disease will be close to 100% curable in 5 years. Many of us who have the virus have had it for decades with little damage. As they say; your mileage may vary.
In a nutshell...... your odds of contracting it from this one incident are very, very remote; 1 in 10K, 100K, my guess.
PS, I would imagine that an AMA or ADA physicians type board might have some sort of stats on splashes to the eye. It is not an unusual concern. Originally it was borne out of fear of HIV transmission. It's good to be cautious. Good for you for asking the question.
best,
Willy