possible infection?

[SmurkyPants]

Hi,

I want to maintain a high degree of anonymity so please bear with me. I was handling a nonhuman biological bone specimen that was processed using a cutting tool in a morgue (which handles human patients). Some water that was present on the surface of the bone splashed into my eye, face, mouth and ears. I know that HCV/HIV are blood borne infections. If there was any human blood (possibly carriers of hcv/hiv) on the cutting tool which got into contact with the bone and the water that was in contact with the bone splashed into my eye/face/mouth/ears, am I at risk of infection? Should I get tested asap? Or do I have to wait a while for the virus to mature?

It might be a stupid question but I'm really stressed about this! Please let me know if you have any insight.

Thanks! :(

[James10500]

In conclusion, blood or other body fluids from
patients who are HCV positive splashing into the face
and eyes is a risk for HCWs
vs.
no transmission
in HCP has been documented from intact or nonintact skin exposures to blood

I hear you about the emotion thing stupid stupid stupid.  

[Trish77]

"Transmission rarely occurs from mucous membrane exposures to blood, and no transmission
in HCP has been documented from intact or nonintact skin exposures to blood. "

Where did you see a contradiction?  I understand that it can occur albeit very rarely from mucous membrane exposures (eyes?) which is why I want to understand the physiology of that .. and no known transmission from skin contact.  I'm not seeing a contradiction?

I understand your emotion ... blood of any kind gives me an initial reaction and then I process logically...mostly. :)

[James10500]

forearm *

[James10500]

My pleasure to post always wanting to learn.

That article is footnote 77 in the above post.

What I thought was interesting from the CDC pdf was this;

Transmission rarely occurs from mucous membrane exposures to blood, and no transmission
in HCP has been documented from intact or nonintact skin exposures to blood.
------------------------------------------
Which seems to contradict the study it references, ?

I know this sounds silly but I was checking this out for myself yesterday.  My body was aching big time Saturday so I got a massage, and man was it a trip when she layed her for arm into my spine my back kept cracking it must have cracked six times.  The massage was great I felt very flexible after...lol.  But it was weird getting touched by someone I didn't know after going through all of this HCV tx and worry the last year.  So I researched it as if I knew nothing about transmission and this is what I came up with.

[Trish77]

Some info on post-mortem transmission.

http://virology-online.com/general/Safety11.htm

[James10500]

here is an interesting part from the cdc; PDF

Risk for Occupational Transmission of HCV
HCV is not transmitted efficiently through occupational exposures to blood. The average
incidence of anti-HCV seroconversion after accidental percutaneous exposure from
an HCV-positive source is 1.8% (range: 0%–7%) (73–76 ), with one study indicating that
transmission occurred only from hollow-bore needles compared with other sharps (75 ).
Transmission rarely occurs from mucous membrane exposures to blood, and no transmission
in HCP has been documented from intact or nonintact skin exposures to blood
(77,78 ). Data are limited on survival of HCV in the environment. In contrast to HBV, the
epidemiologic data for HCV suggest that environmental contamination with blood containing
HCV is not a significant risk for transmission in the health-care setting (79,80 ),
with the possible exception of the hemodialysis setting where HCV transmission related
to environmental contamination and poor infection-control practices have been implicated
(81–84 ). The risk for transmission from exposure to fluids or tissues other than
HCV-infected blood also has not been quantified but is expected to be low.

[Trish77]

"In conclusion, blood or other body fluids from
patients who are HCV positive splashing into the face
and eyes is a risk for HCWs. HCWs should be educated
to prevent a nosocomial acquisition of hepatitis C
infection. The current case is a typical illustration of
the cost-effectiveness of institutional education and
precaution. The treatment of HCV infection with
interferon is more expensive than the cost of education
and prevention equipment. HCWs should observe the
protective precautions of their workplace."

Interesting article, James.  I would like to understand why the splashing in eyes and face is a risk - albeit a very low risk, according to the article - for HCW's or anyone in contact with human blood in medical settings.  At one time, snorting coke from a straw wasn't thought to be a vehicle for transmission either until it was better understood what occurs, that membranes inside the nose can rupture and bleed, and now we know.  Thanks for posting that.

Trish

[James10500]

I also found this;

http://www.cdc.gov/mmwr/PDF/RR/RR5011.pdf

Page 6

[James10500]

This may help.  Anyone interested give it a read especially us regulars.

http://www.heart-intl.net/HEART/011507/TransmissionofHepatitis.pdf

[Trish77]

I'm sure there are morgues in every city around Canada and the U.S. You're reasonably safe I would think - sometimes safer than talking to a live person who knows other people that know you and can betray a confidence.  Well, unless you're using your undercover code name and then in that case ....well, HIV/HCV is the least of your worries. :-\

And...not to add to your anxiety but there is Hep B that is far more contagious in this scenario than HIV or Hep C.

I don't know if you used your cutting tool on a human immediately prior to using it on a non-human (sounds like something out of a CSI episode) however HIV dies almost instantly on a surface - your cutting tool - and HCV lives approximately 16 hours on a surface, longer within a syringe but that's not what we're talking about. HCV is a blood infection but has to get directly into your bloodstream for effective transmission.  Landing on your skin or in your ears isn't going to do it, there would have to be an open wound of some kind where a bit of blood in your scenario would make it to some random cut on your body in the area you were splashed and enter your bloodstream.  Seems like a whole lot of "if's" in that scenario.

If you still can't settle your mind down, check out this link to determine what test would apply to your level of concern and when you want to go.

http://www.labtestsonline.org/understanding/analytes/hepatitis_c/test.html