Clarity Needed

[Bitofahypochondriac]

Hi Doctor,

I was wondering whether I was at risk from something earlier today. I was at a very popular beach all day today and at one point I stepped on something that resulted in a deep prick on the bottom my toe. The wound has been sore since all the way until the time of writing. I am unsure as to what caused this wound as I stupidly did not look back to check. I know there is a variety of things that could have caused such a wound but, although unlikely, hypothetically speaking if it was in fact a used needle or syringe, would I be much at risk from a blood virus like HIV? I have read a variety of things that say the virus is unstable and only lives for a few minutes outside the body - while other sources say that it can survive inside a needle/syringe for up to 48 days. I should point out that the area I suffered this wound in was occupied by my friends for over an hour and it was about 85 degrees outside [in Florida]. Should I be considering something like PEP?

Thanks

[Edward W Hook, MD]

Hypothetically, the virus might survive within the lumen of a needle for several hours. Precisely how long is unknown but again, it is probably not too long.  Realistically however, there is virtually no risk from the "exposure" you describe. EWH

[Bitofahypochondriac]

Thanks for your advice Dr. Hook,

My tetanus is up to date. Like I said I am unsure as to what I stepped on to cause this wound although I can say that it did not draw blood from me but caused a pretty deep prick and a stinging pain. Sorry to speak in hypotheticals again, but does the fact that this incident happened during the afternoon [3pm - which would make it unlikely that anyone would have been using needles in broad daylight]  and due to the heat and humidity - potentially have an effect on the chances of picking up something like the HIV virus from a needle prick? Can the virus survive 'inside' a needle or syringe in that enviornment?

As I mentioned before what drove me to post was the fact that the injury has continued to cause me discomfort until the present - though I'm not sure whether this shows anything.

Thanks again - your advice has been of great help.

[Edward W Hook, MD]

Welcome to the Forum.  I'll try to help.   The odds that what you stepped on was a used needle from an HIV infected person that contained living HIV are incredibly low.   As you have heard HIV dies quickly in the environment.  Finally, please remember that PEP is both expensive (typically >$1000) and has side effects (usually mild to modest but sometimes severe) associate with it.  If you came to me and asked for PEP I could not give it to you with good conscience.  My advice is to not worry but to make sure your tetanus immunization is up to date.  EWH