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Occupational Exposure- Your Friend Me Again Please

Jul 22, 2006

Hi Dr. Frascino, its me again. Im the healthcare worker who might have been unknowingly exposed while I was concentrating on taking care of a patient. Just a few more things I forgot to add. In my previous note (which follows) I stated that I had not noted any fever, but now come to think of it, sometimes during the day my temp would go up to 99.4 or so then down again after maybe a few hours. But before the possible exposure my normal body temp was around 97.4. I read that Seroconversion illness can be accompanied by low-grade fever.

1) I know that body temperatures normally fluctuate during the day, but with my normal temp being around 97.4 would you call 99.4 a fever? 2) Does the Seroconversion fever go up and down during the day? 3) Does your assessment of my risk change based on this new information? 4) Could my skins own dendritic cells have done me in by trying to help me get rid of foreign particles but all the while bringing HIV just where it wanted to go (to my lymphocytes)? 5) Do I just have an overactive imagination? I know that symptoms cannot diagnose HIV, but the timing of the symptoms in relation to the possible exposure is whats driving me insane with worry. It seems to be perfect for HIV.

As always thank you so much. My donation is coming to you in the form of a money order.

Your Friend Me

Here is my previous post:

Possible Occupational Exposure And Seroconversion-Revised Jul 19, 2006 Hi Dr. Frascino. My story began on 4/26/06 when at work a patients bloody sheet might have contacted some areas of eczema on my arms. I had forgotten about the areas because the eczema was not running or bleeding. There was however burning with alcohol (I tested it after the event). The blood on the sheet might have been starting to dry because it was brownish red. I dont recall feeling anything wet, but the mind plays tricks. I would not have thought anything further about the event, but on 6/21/06 I started having muscle aches that came and went and changed places, from hips, thighs, forearms, upper arms etc., but were more constant in the lower part of my legs. I also had painful lymph nodes mostly just around my neck along with some streaking pains in my head and my ears that came and went back and forth. No fever noted. I had the symptoms off and on until about 7/7. Im not the type that gets muscle aches like that even when I have the flu. I noted some rash on the upper part of my chest more on the right side close together. It looks like if you tried you could count them. There are a few scattered bumps on the left side. I think they started appearing little by little on 7/10. They dont itch which I understand is (unfortunately for me) consistent with the ARS rash. They are still here today 7/14/06. Still no fever detected. The patient (who had been using cocaine) cannot be tested now since he is deceased. I took what the testing center told me was a 3rd generation HIV test on 7/11 which was 76 days (almost 11 weeks) from the event and 20 days (almost 3 weeks) from the start of symptoms. The test was negative. 1) Do these symptoms sound like those of the acute seroconversion illness? 2) If the symptoms were from seroconversion, would the test show something by almost 11 weeks from the event and almost 3 weeks from the start of symptoms like at least indeterminate? 3) If I contracted Hepatitis B or C along with HIV, would the window period for HIV still be 3 months? 4) Is the window period longer for healthcare workers than for anyone else? If so, why? Some places are still recommending up to a year of testing. 5) How nonintact does nonintact skin have to be for transmission to occur? Does it need to be bleeding? 6) How long can HIV remain active and able to infect if it was in the blood described above? 7) How likely do you think I am to be able to Woo Hoo when all is said and done? I am under a boatload of stress from this. Thank you so much for answering. I think the work you are doing is fantastic. Id like to send a donation. I saw an old address of 779 Altos Oaks. If I have the correct current address Ill be sending it to 1000 Fremont Ave., Suite 145, Los Altos, CA 94024. Is this correct? Again thanks for everything. Your Friend Me

Response from Dr. Frascino

Hello, Your HIV risk is negligible at best. 1. No. 2. Yes, most likely it would. 3. Yes, in most cases. 4. The window period is not really longer; however, in some cases (not yours), a repeat test at six months is recommended for other reasons. 5. There are many factors that come into play here -- not only how "non-intact" the skin is, but also viral load, nature of the exposure, duration of exposure, etc. 6. There is no absolute time. The best I can offer is that HIV does not live very long at all outside the body. 7. Very very likely! The new address for The Robert James Frascino AIDS Foundation is: 1000 Fremont Ave., Suite 145 Los Altos, CA 94024 Thank you for your donation! I'll send my best good-luck karma in return, and I'll look forward to your definitive WOO-HOO!! Dr. Bob

Response from Dr. Frascino

Hello Your Friend Me,

1. Nope! I'd chalk it up to global warming. (Go see Al Gore's movie, "An Inconvenient Truth" and you'll see what I mean.)

2. No, it's more similar to the fevers you would see with the flu.

3. Nope!

4. No.

5. Absofrickinlutely! Your 11-week negative 3rd generation HIV-antibody test (three weeks after your "symptoms") is extremely, extremely encouraging. My advice is to get a 12-week rapid test. The results will be ready in 20 minutes and you'll be WOO-HOO-ing at 20 minutes plus 1 second. I can almost guarantee it.

Thank you for your donation. I'll send back a formal (Miss Manner's approved) written acknowledgement and thank you as soon as the donation arrives. I'm sending an extra dose of good-luck karma, although in reality I highly doubt you're going to need it.

I'll be waiting for that WOO-HOO!

Dr. Bob

Children, Cuts, and Saliva

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