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Needle Stick
Apr 2, 2002

Dear Dr.Frascino, I am a paramedic who was stuck with a needle on the index finger the other day. What are the chances of seroconversion and after how many weeks will antibodies show up on the elisa if I was infected? How long did it take for you to test positive after your needle stick and did you have the classic flu-like symptoms soon after? I'd appreciate any info as I'm very, very worried. Thank you & god bless.

Response from Dr. Frascino

Hello Paramedic,

Needle sticks in health care professionals are extremely common. Your overall risk is 0.03%. That's a 1 in 300-400 chance. In other words, the risk is quite small. Do you know the source patients HIV status? If you know the source patient and they have never been tested for HIV (and hepatitis), you could let him or her know what happened and ask them to be tested. Medical institutions usually have a mechanism set up to do this confidentially. If the source patient is negative, you are safe. If you know the source patient is HIV-positive, you should consider post-exposure prophylaxis. That means taking anti-HIV meds for 4 weeks. The choice of which meds in this case would depend on the source patient's anti-HIV medication history. These medications should be started as soon as possible after the exposure. An HIV specialist can help you further evaluate your potential risk and modify your medications, if needed.

My case? I took AZT within moments of my exposure. I was performing a procedure on a patient with advanced stage AIDS and sustained a significant laceration and deep stick with a hollow-bore needle. That was in 1991. Today, we use at least 2 drugs for PEP (post exposure prophylaxis). I had a very typical seroconversion reaction - severe flu-like illness - and seroconverted shortly thereafter. Cases like mine are really very rare compared to the number of needle sticks that occur everyday in our work as health care professionals. The odds are all in your favor. The CDC's full guidelines for post-exposure prophylaxis can be found at www.cdc.gov/mmwr/preview/mmwrhtm. Remember to test for hepatitis B and C as well as HIV, as they are also potentially transmitted by needle stick injuries. You should also file a confidential incident report with your agency for insurance purposes.

Good luck. Chances are you are fine, but do follow up if you sustained a significant needle stick.

Dr. Bob


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