RD17 (2011) Infectious Diseases

 

Blood borne viruses:

 

Risk and treatment:

Virus

Risk

Treatment

HIV

0.3%

·         Post-exposure prophylaxis (aim <2, ok <72h)

·         Suppressive treatment

HCV

3%

·         Curative treatment

HBV

30%

·         Vaccine ± booster (give STAT if unvaccinated)

 

Post-exposure management:

·        Wash +++

·        Call infection control: risk assessment + planning

·        Test self: HBV surface antigen

·        Test patient: HBV, HCV, HIV (need consent)

·        ±Treatment

·        ±Follow up

·        Maintain confidentiality

·        Seek support – mentor etc

 

Risk of transmission dependent upon:

·        Extent of injury (deep > superficial)

·        Item causing injury (hollow bore > solid)

·        Body fluid (blood > other)

·        Volume

 

Other:

 

Respiratory transmission:

Droplet

(normal mask)

·      Cold

·      Flu

·      Pneumonia

·      Streptococcal throat

·      Whooping cough

Airborne

(N95 mask)

·      SARS

·      TB

·      Measles

·      VZV

 

Vaccinations required for:

·        HAV

·        HBV

·        Influenza (70-90% effective)

·        DTP

·        MMR

·        HAV

·        BCG (if TB is endemic; only 50% effective)

 

Standard precautions:

·        Safe handling of sharps

·        Cough etiquette

·        Respiratory hygiene

·        Gloves

·        Mask

·        Goggles

 

Personal responsibilities:

·        Have proof of immunization status

·        Know one’s blood-borne virus status

·        Inform employer and stop clinical work if infected

·        Routine blood tests every 1-2 years (!)

·        Should have ‘needle-stick cover’ insurance