During their work, healthcare workers are exposed to the risk of becoming infected with pathogenic blood-borne viruses, among which we know (HBV), (HCV) and (HIV). Physical contact with infected material occurs when accidental punctures or cuts with sharp instruments contain traces of the patient's blood or when it comes into contact with the mucous membranes of the eyes, nose and mouth or the surface of the skin. General indicator The risk of occupational infection with blood transfusion infection is determined by the following factors: the proportion of infected patients in the population served, the probability of infection from a single contact with infected blood, the type and number of such contacts. That is why every patient, regardless of diagnosis, is considered a potential source of infectious agents, including those transmitted through blood.
In most cases, exposure is not accompanied by infection. The risk of infection in each specific case depends on the following factors: type of pathogen, nature of exposure, amount of infected blood likely to have entered the victim’s body, virus content in the patient’s blood at the time of exposure.
Health care workers who have been vaccinated against are practically not at risk of infection from an accidental puncture or cut, which is accompanied by contact with infected blood. In unvaccinated individuals, the risk of infection ranges from 6 before 30 % and depends on the condition of the source patient.
Based on a limited number of studies, the likelihood of an accidental stick or cut resulting in exposure to infected blood is approximately 1,8% . Risk of infection if blood comes into contact with mucous membranes or skin unknown, but believed to be very small; however, similar cases have been reported in the scientific literature.
The average probability of an accidental puncture or cut, which is accompanied by contact with infected blood, is 0,3% (three tenths of one percent, or one chance in 300). In other words, 99,7% such cases do not lead to infection. If HIV-infected blood gets into your eyes, nose, or mouth, the average chance of infection is 0,1% (one chance in a thousand). If HIV-infected blood comes into contact with your skin, you are less likely to become infected. 0,1% . The contact of a small amount of blood on intact skin does not pose any danger at all - in any case, there is no documented evidence of infection under such circumstances (a few drops of blood on intact skin for a short time). The risk may increase if the skin is broken (such as a recent cut) or if it comes into contact with infected blood.
If blood or other potentially hazardous body fluids come into contact with your eyes:
- the eye is washed with water or saline solution;
- ! not allowed washing eyes with soap or disinfectant solution;
- ! not allowed removing contact lenses while rinsing the eyes because they act as an additional barrier. After washing the eyes contact lenses removed and processed in the usual way, after which they are considered safe for further use.
If blood or other potentially hazardous biological fluids come into contact with the oral mucosa:
- liquid trapped in the oral cavity, spat out;
- the oral cavity is washed several times with water or saline;
- for rinsing the mouth not allowed use of soap or disinfectant solutions.
There is currently no scientific evidence to support the ability to reduce the risk of infection when using antiseptic drugs or squeezing out wound contents. Not recommended for use caustic substances such as alkaline bleaches.
Option 1: Emergency prophylaxis of parenteral viral hepatitis and HIV infections (Appendix 12 to SanPiN 2.1.3.2630-10)
To avoid infection with parenteral viral hepatitis and HIV infection, you should follow the rules for working with piercing and cutting instruments.
In case of cuts and injections, immediately treat and remove gloves, squeeze out blood from the wound, wash your hands with soap and running water, treat your hands with 70% alcohol, lubricate the wound with a 5% iodine solution.
If blood or other body fluids come into contact with skin this area is treated with 70% alcohol, washed with soap and water and re-treated with 70% alcohol.
If blood gets on the mucous membranes of the eyes, they are immediately washed with water or a 1% solution boric acid; in case of contact with the nasal mucosa, treat with a 1% solution of protargol; on the oral mucosa - rinse with a 70% alcohol solution or a 0.05% solution of potassium permanganate or a 1% solution of boric acid.
The mucous membranes of the nose, lips, and conjunctiva are also treated with a solution of potassium permanganate at a dilution of 1:10,000 (the solution is prepared ex tempore).
With the aim of emergency prevention HIV infections are prescribed azidothymidine for 1 month. The combination of azidothymidine (Retrovir) and lamivudine (Elivir) enhances antiretroviral activity and overcomes the formation of resistant strains.
If there is a high risk of contracting HIV infection (deep cut, visible blood on damaged skin and mucous membranes from patients infected with HIV) to prescribe chemoprophylaxis, you should contact the territorial Centers for the Control and Prevention of AIDS.
Persons exposed to the threat of HIV infection are under the supervision of an infectious disease specialist for 1 year with mandatory examination for the presence of a marker of HIV infection.
Personnel who have had contact with material infected with the hepatitis B virus are simultaneously administered specific immunoglobulin (no later than 48 hours) and a vaccine against hepatitis B in different parts of the body according to the scheme 0 - 1 - 2 - 6 months. with subsequent monitoring of hepatitis markers (not earlier than 3 - 4 months after the administration of immunoglobulin).
If the exposure occurred in a previously vaccinated health care worker, it is advisable to determine the level of anti-HBs in the blood serum. If there is an antibody concentration in the titer of 10 IU/l or higher, vaccine prophylaxis is not carried out; in the absence of antibodies, it is advisable to simultaneously administer 1 dose of immunoglobulin and a booster dose of the vaccine.
Option 2: Actions of a medical worker in an emergency (Resolution of the Chief State Sanitary Doctor of the Russian Federation dated January 11, 2011 No. 1 “On approval of SP 3.1.5.2826-10 “Prevention of HIV infection”).
In case of cuts and injections, immediately remove gloves, wash your hands with soap and running water, treat your hands with 70% alcohol, lubricate the wound with 5% alcohol solution iodine;
- if blood or other biological fluids come into contact with the skin, the area is treated with 70% alcohol, washed with soap and water and re-treated with 70% alcohol;
- if the patient’s blood and other biological fluids come into contact with the mucous membranes of the eyes, nose and mouth: oral cavity rinse with plenty of water and rinse with a 70% solution of ethyl alcohol, the mucous membrane of the nose and eyes are rinsed with plenty of water (do not rub);
- if the patient’s blood or other biological fluids get on the gown or clothes: remove the work clothes and immerse them in a disinfectant solution or in a tank (tank) for autoclaving;
- start taking antiretroviral drugs as soon as possible for post-exposure prophylaxis of HIV infection.
It is necessary, as soon as possible after contact, to test for HIV and viral hepatitis B and C the person who may be a potential source of infection, and the person in contact with him. HIV testing of a potential source of HIV infection and a contact person is carried out using rapid testing for HIV antibodies after an emergency with the obligatory sending of a sample from the same portion of blood for standard HIV testing in an ELISA. Blood plasma (or serum) samples of a person who is a potential source of infection and a contact person are transferred for storage for 12 months to the subject’s AIDS center Russian Federation.
The victim and the person who may be a potential source of infection must be asked about the carriage of viral hepatitis, STIs, inflammatory diseases genitourinary tract, other diseases, provide counseling regarding less risky behavior. If the source is infected with HIV, determine whether he or she received antiretroviral therapy. If the victim is a woman, a pregnancy test should be performed to determine if she is breastfeeding. In the absence of clarifying data, post-exposure prophylaxis begins immediately when additional information the scheme is being adjusted.
Carrying out post-exposure prophylaxis of HIV infection with antiretroviral drugs:
Antiretroviral medications should be started within the first two hours after the accident, but no later than 72 hours.
The standard regimen for post-exposure prophylaxis of HIV infection is lopinavir/ritonavir + zidovudine/lamivudine. In the absence of these drugs, any other antiretroviral drugs can be used to initiate chemoprophylaxis; If it is not possible to immediately prescribe a full-fledged HAART regimen, one or two available drugs are started.
The use of nevirapine and abacavir is possible only in the absence of other drugs. If the only available drug is nevirapine, only one dose of the drug should be prescribed - 0.2 g (repeated administration is unacceptable), then when other drugs are received, full-fledged chemoprophylaxis is prescribed. If chemoprophylaxis is started with abacavir, testing for hypersensitivity reactions to it should be carried out as soon as possible or abacavir should be replaced with another NRTI.
Registration of an emergency situation is carried out in accordance with established requirements:
- LPO employees must immediately report each emergency to the head of the unit, his deputy or a senior manager;
- injuries received by health workers must be taken into account in each health care facility and registered as an industrial accident with the drawing up of an Industrial Accident Report;
- you should fill out the Occupational Accident Register;
- it is necessary to conduct an epidemiological investigation of the cause of the injury and establish a connection between the cause of the injury and the performance of official duties by the health worker.
All healthcare facilities should be provided with, or have access to, rapid HIV tests and antiretroviral drugs as needed. A stock of antiretroviral drugs should be stored in any health care facility at the discretion of the health authorities of the constituent entities of the Russian Federation, but in such a way that examination and treatment can be organized within 2 hours after an emergency.
The authorized health care facility must identify a specialist responsible for the storage of antiretroviral drugs, a storage location with access, including at night and on weekends.
Sequence of processing of dental instruments Used dental instruments and materials are disinfected after each patient. If tools and materials are disposable, they must be disposed of safely. Before cotton swabs, plastic saliva ejectors, etc. are sent to the city landfill, they should be disinfected by immersing them for one hour in a 1% chloramine solution, or a 6% hydrogen peroxide solution, or a 3% bleach solution, or for 30 minutes in a solution of incrasept. After each patient, the tips of drills, waste pads, air and water pistols, and ultrasonic devices for removing dental plaque are treated twice with 70° alcohol and at the end of the shift they are treated with 3% chloramine for 60 minutes or incrasept solution for 30 minutes. Instruments that have come into contact with the patient's mucous membrane and are contaminated with biological fluids (dental hand instruments, glasses, mirrors, burs) and gloves are disinfected immediately after use, then undergo pre-sterilization treatment and sterilization. Disinfection is carried out by total immersion used instruments for 30 minutes in a container with incrasept solution (3% chloramine for 60 minutes or 6% hydrogen peroxide solution for 60 minutes, or 2% Virkons solution for 10 minutes, or Sidex solution for 15 minutes can also be used , or 0.1% chlorsept solution for 60 minutes). Disinfectant solution used six times, after which it is changed. Next, the instruments undergo pre-sterilization treatment: the instruments are immersed in another container with an incrasept solution at t = 20-45°, where each instrument is washed with a brush for 15 s; wash the instruments with running water; rinse with distilled water; check the quality of purification: from blood - with an azapyran test (if the test is positive, repeat the entire pre-sterilization treatment); from alkali - phenolphthalein test (if the test is positive, repeat steps 2 and 3); instruments are wiped with dry towels or dried with hot air until the moisture disappears. Products made of glass, metals, and silicone rubber are sterilized without packaging (in open containers) or in paper packaging using the dry-heat method (dry hot air). Sterilization mode: 60 min at t=180°. Polishers, working parts of dental plaque removal devices and burs are treated in the same way as instruments. Dental mirrors are subjected to disinfection, then pre-sterilization treatment (items 2, 3 and 4), after which they are sterilized with glass beads at high temperature: Stored in Petri dishes. Rubber gloves, cotton swabs, products made of polymers, textiles, latex are sterilized in containers by autoclaving in two modes: at t = 120°, pressure 1 atm. for 45 minutes or at t = 132°, pressure 2 atm. within 30 min. The shelf life of the sterility of instruments in sealed packaging (in a bag, in a kraft paper bag) is three days; after opening the bag, the material in it is considered sterile during the working day. Features of organizing the reception of patients with increased risk infections.
IN Lately The problem of the spread of immunodeficiency in Russia is particularly acute. Poor awareness of citizens about methods of infection, the course of the disease, and preventive measures has led to the fact that this moment the number of patients exceeded one million people.
Illiteracy of people gives rise to a large number of myths and related questions, for example, what will happen if HIV saliva gets into the eye. These unclear situations only make the problem worse. On the one hand, they do not contribute in any way to improving the infection safety of citizens, on the other hand, they enhance negative attitude towards patients suffering from this disease, increasing the degree of their alienation from society.
One of these myths is the transmission of HIV through saliva and mucous membranes. In particular, when HIV gets into the eye, for example, during sex. Repeated studies over a long period of time indicate that the possibility of infection in this case is practically absent. Therefore, the answer to the question: is it possible to become infected with HIV through the eye?
But what to do if HIV saliva gets into your eye? First of all, you need not to panic; to date, not a single case of infection through the mucous membrane using saliva has been recorded. You should go to a medical facility, undergo an examination and take tests.
There is an unjustified fear of infection not only when HIV saliva gets into the eye, but also through tactile contact, in in public places, swimming pools, showers and more. The infection is not transmitted through the bites of various insects, although at one time it was suggested that the rapid spread of the disease was due to the activity of malaria mosquitoes, modern research this is not confirmed. In the open air, the retrovirus is extremely unstable and cannot exist for a long time without a carrier.
At the moment, it is officially believed that transmission of infection is possible through blood, vaginal discharge, semen and breast milk. Therefore, if HIV blood gets into the eye, the chances of infection are relatively high. Therefore, immediate contact with a medical institution is mandatory. Here they will prescribe testing and offer preventive therapy that will help reduce the risk of contracting immunodeficiency if HIV blood gets into the eye.
People have been attacked by the human immunodeficiency virus for decades. Pathogenic flora penetrates the body and gradually kills it. Every day many HIV infections occur through blood. This is due to lack of awareness of people, promiscuous sex life, drug addiction, increased crime, low level life and other unfavorable factors. The blood of an HIV-infected person is a potential breeding ground for the disease, but infection does not always occur.
Blood with AIDS is only dangerous if it comes into contact with the secretions and bodily fluids of a healthy person. Today, everyone needs to know the specifics of virus transmission in order to protect themselves from the transmission of AIDS and HIV through blood. By familiarizing yourself with the mechanism of infection and the peculiarities of the introduction of a retrovirus into cells, you can minimize the risk of developing many life-threatening diseases, including immunodeficiency.
Is HIV transmitted through dried blood?
Due to different life circumstances, each person may face the fear of contracting HIV. Contact with the blood of an infected person does not always lead to the worst results. This is due to the fact that physical and chemical characteristics This biological fluid has many variations. Infection is possible only if HIV blood enters the blood of an absolutely healthy person through open wound, microcracks in the mucous membranes. In order for pathogenic cells to begin to actively multiply in the body of a healthy person, they must enter maximum quantity into an acceptable habitat. Otherwise, infection does not occur.
Doctors are often asked questions about whether the dried blood of an HIV-positive person is dangerous. There simply cannot be an unambiguous and clear answer here for several reasons. Firstly, the freshness of dried blood plays a huge role. Whether it is possible to become infected with HIV through biological material that has been exposed to the open air for a long period of time is a controversial issue. The fact is that virus cells remain viable for 2 weeks even in dried blood. How many HIV cells live in this type of material depends on the stage of the person’s disease and the degree of mutation of the virus. If the blood of a patient infected with AIDS contains few pathogenic cells, then it becomes safe within a few days. Cells do not die immediately, but gradually.
It is possible to become infected with HIV/AIDS through blood that has dried less than a few hours ago. However, for this to happen there must be direct contact between infected and healthy biological material. This means that a person gets sick and becomes a carrier of the virus only if the dried blood of an HIV-infected person enters through an open wound on the body or microcracks in the mucous membranes.
In addition, the parenteral route of transmission and infection of HIV through blood includes the use of non-sterile medical instruments, for example, scalpels and needles. Dried biological material in small quantities may remain on syringes and drills. This route of infection predominates among drug addicts, as they often share injection needles. Through parenteral transmission of HIV infection, you can also become infected in medical institutions. Transfusion medical supplies, reuse of needles and syringes, and insufficiently disinfected surfaces increase the risk of infection. Hospitals must strictly monitor the integrity of medical personnel.
Does infection occur when the material enters the mouth?
Communication with retrovirus carriers is in itself absolutely safe. However, sometimes situations arise that are fraught with unpleasant consequences for a healthy person. You can often hear or read on forums the question of whether it is possible to become infected with HIV by drinking the blood of a patient. At first glance, such a topic may seem funny, because no one in their right mind would drink it, especially if it’s contaminated dangerous virus. Even more ridiculous is the question of whether one can become infected by eating dried HIV blood. However, life is unpredictable, and situations are also different.
The entry of infected biological material into the stomach, and from there into the intestines, can occur when eating food prepared by infected cooks. Cooking is a process that is fraught with various types of injuries. The cook may not know that the disease has affected his body and continue to work in catering establishments. The slightest cut of a chef's finger with a knife can end disastrously for the visitor if biological fluid gets into the food, and from there into the body of a healthy person. This also applies to drinks. If there is biological material of an infected person on the glasses or cups, then the issue of infection through the dried substance becomes relevant.
The risk of infection in this way is 50:50. This depends on the amount of biological material and the presence of open ulcers and wounds in the body. To be infected with HIV, the minimum amount of blood must be more than one teaspoon. In addition, the risk of infection increases if the biological material is fresh. It is difficult to say how long HIV lives in dried blood on dishes and cutlery. On average, pathologically altered virus cells are active for up to 2 weeks. Only after this period of time has passed can we talk about their complete destruction.
How much blood does it take to become infected with HIV? This question is asked quite often today. This number is different for everyone. However, if there are ulcers and wounds in the intestines or stomach, then one drop is enough. If internal organs In ideal condition, it will take about a glass of blood to become infected. Only this amount will be absorbed by the intestinal walls and enter the bloodstream.
Outside the body, HIV in the blood does not pose any danger. If HIV blood has entered the stomach, then you need to see a doctor in two weeks and take all tests to detect the infection.
Is an infected biological substance dangerous during menstruation?
The topic of sex is extremely sensitive. Quite often, people whose partner has AIDS have questions about whether it is possible to become infected with HIV during menstruation. Answer in in this case ambiguous. If during this period of time the couple has unprotected sexual intercourse or oral sex occurs, then infection is possible.
It happens that there is household contact with linen soiled from menstruation. In this case, you need to ensure that discharge from clothes and sheets does not get on an open wound on the body. If, by pure chance, you touch underwear contaminated with such biological material, then nothing bad will happen. The skin is a reliable barrier to prevent the penetration of the virus.
Sometimes a patient may come to see a doctor and wonder how she became infected with HIV during her period. Many people mistakenly believe that the virus comes out along with the discharge. However, this is fundamentally wrong. The day of the cycle does not matter. Infection is possible at any time if sexual intercourse is performed without a condom or if it is damaged.
I work as an emergency room nurse. Very worried. How often should I get tested?
I am very concerned about which way you can get infected with HIV and hepatitis faster: through blood or semen? And what quantity of bio-material is needed for infection?
9 months ago I was hospitalized and met a girl there. Our friendship quickly grew into great feelings called love. For 2 weeks we stayed together in the same hospital, slept on the same bed, ate from the same dishes. Fortunately, it didn’t come to intimacy; everything was limited to sensitive, deep French kisses. I was shocked when I found out that the person to whom I was ready to give my soul hid from me the fact that he had AIDS. It turns out that there is no such law that those infected and healthy people were on different sides this world, that’s why she and I ended up in the same room. The doctors knew about my friend’s illness, but they hid it from me, although they saw our tender relationship with each other. I want to ask you: 9 months have passed since then, I only found out 3 weeks ago that she has AIDS. I immediately took ELISA-HIV tests, the result was negative. But these kisses haunt me. Moreover, at that time I had malaria on my lip and, of course, its saliva got into the wound. Tell me, do I now have to take an HIV test every three months for life? Since I read that the latent form of the virus can remain in the body for 3 to 5 years and not a single marker can detect it.
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Answers Eric, HIV consultant
Dasha, hello. 1) no 2) zero 3) if infected blood or other liquid with a high concentration of HIV gets into the mucous membrane of the eye, there is some risk of infection.
Is the answer helpful? Yes 17 / No 3
Answers Eric, HIV consultant
Read carefully again:
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Is the answer helpful? Yes 5 / No 5
Answers Eric, HIV consultant
