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CDC and physican gave me different answer who to trust?
Jun 14, 2002

Dr. Kull,

This is the third time I posted this question. Hope I can get your answer this time. I am really going nuts now! Four days ago, I helped a stranger to change her tire. She handed me the tools. Then when I changed the tire, my hand got scratched by the sharp end of the tool and started bleeding. I know that I cannot get infected just by a scratch, but since she has so many stuff (clothes, etc.)in her trunk, I am not sure if she got scracted first when she looked for the tool then I got scratched at the same spot. Although the chance is very rare, but it still exists, right? Second morning (less than 15 hours), I started feeling sore throat. So I called CDC and asked them about HIV infection through this incident. The gentleman who answered the phone laughed at me and told me that I am not at any risk. Started this morning (3 days after the incident), my sore throat got pretty bad, and I started to get fever(99.5) and headache. So I went to see my physician. After I told him about the incident, he told me that it is possible to be ARS based on the symptoms and the incident. He told me to run a test three months later. This made me really nervous. I don't know if I can hold on for 3 months or not. So now I want to get an answer from you, the expert in HIV. Whose answer is more reasonable, who should I trust? Thanks.

Response from Mr. Kull

You should generally be able to trust the CDC and your physician. It is important to remember that health professionals, educators, experts, etc., can make mistakes, which is why asking questions, educating yourself, and getting other opinions can be useful in healthcare. Since there isn't always one answer or a definite answer to questions in healthcare, you may get different responses and be required to make informed decisions on your own.

It is extremely, extremely unlikely that you would get infected in the incident you describe. The CDC tracks how HIV is spread in the United States, and three modes of transmission have been identified:

1) Sexual contact: anal, vaginal, and oral sex

2) Blood-to-blood contact: sharing injection needles, occupational exposures, blood transfusions (which is rare in the U.S.). This does not include accidental cuts in the day-to-day environment (HIV does not survive in the environment long enough to pose a risk through contact of this sort).

3) Mother-to-infant: either through delivery or during breast feeding

There are no other known routes of transmission. That, among many other reasons, suggests that you are not experiencing ARS. I wouldn't even advise testing at three months, unless you have other risks (such as sexual exposures).

Have you received tetanus immunization in the past? If you haven't had a tetanus shot in the past ten years and the wound or tool was dirty, you might want to talk with your doctor (if you haven't already) about receiving a tetanus immunization shot/booster.

RMK



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