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Urgent: exposure to HCV-positive ascites fluid
May 6, 2012

Good morning! I am a medical student. I have a question about a blood borne pathogen exposure that happened to me. I was working a shift in the Emergency Department when I was assisting in a peritoneal tap of a patient with massive ascites due to alcoholic/HCV cirrhosis. Over the course of the procedure, my unprotected fingers touched a piece of equipment packaging that may have been in contact with ascites, because the ascites had been splashing everywhere. I did not think too much of this at first, because my finger did not feel anything wet or moist on contact. Right after the procedure I used some alcoholic Purell hand sanitizer, and felt a sting on my finger. I took a look and saw a previously undiscovered hangnail abrasion on my finger. The abrasion was not bleeding, but it looked less than 24 hours old. I was therefore concerned about my blood stream contacting with HCV-infected ascites fluid. I therefore wiped my hands with cavi-wipes a short time later, and rinsed my hands in water. I have scoured the internet and literature for more information but found a lot of conflicting or inconclusive information. My questions are: do you think I am at risk for HCV transmission from the ascites possibly coming into contact with my skin abrasion? Do you think the initial Purell use deactivated the HCV? Should I get an HCV RNA test to find out early if I became infected? I would definitely appreciate any insights you have on these matters. Thank you for your time!

Sincerely, Worried medical student

Response from Dr. McGovern

As a medical student you should get proper advice from your medical school student health service. I will say that the event you describe would not prompt me to recommend further testing.



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