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Exposure to HEPC/HIV Please help a healthcare volunteer .. 5th time trying! Have stopped volunteering and feel miserable abt it!!!!
Jun 18, 2007

I work as a volunteer at the VA( first time dealing with blood). Today after I centrifuged some blood from an old black male(HepC positive/unknown HIV) I was putting the plasma into cryovials. I splashed a drop on my face.I know I did because I felt a small cold drop next to my mouth but not close to it(between my cheek and mouth) . The pipette I was using had formed a bubble on the end and when I pushed the air it caused the bubble to pop. I was wearing goggles and gloves and a coat but no mask! Ok here comes my stupidest mistake! The minute I felt the drop or speck(I dont know)I just brushed it off with my sleeve as a reflex and continued with my work ( did not wash it off!!!).I did not perceive it as a risk since it was on skin i jus nonchalantly brushed it off( I did not know I was dealing with infected blood).I am always careful but when the time came to be really careful when dealing with any kind of blood I let myself down!I didnt think about it till I went home that day and the next day reported the incident to occupational health. The doctor examined my skin and in his report wrote that it was a low risk exposure, he examined my skin as intact with no abrasions or cuts. My biggest worry is that I did have tiny bumps on my face but not inflammed acne.Would the viruses have found their way through my skin because of prolonged contact? 1. Would that be non intact skin? 2.What is my risk for contracting HepC/HIV? I am about to lose my mind over this possible exposure. . 3.Also, would the amount of time that the blood had been outside his body(4 hrs) and the fact that it had centrifuged for 20 minutes have lowered any possible risks?

The occupational health doctor is testing me for HIV/HepC/HepB even though the pt is Hep B immune. I asked him about PEP and he said he wouldnt think it was required but he says he isnt sure if any of the plasma got inside my body so the best way is to just follow testing protocol.

Also another possible exposure I remember is that I was helping my supervisor transfer some samples from a cooler keg filled with ice from one fridge to another. They were blood samples packed inside plastic bags. While picking out the bags I might have squeezed on one bag and the condensed water outside the bag splashed onto my mouth(lips). Again i just brushed it off since my instinct told me it was just water condensed from the ice the bags were in. As mind is a terrible thing later I started obsessing about possible water contamination. What if the water on the bags was infected with traces of blood ? Again I never washed just wiped off the water!!!! I have terrible insticts/common sense ! I dont know what I have against washing off stuff! I guess I have learnt the importance of protecting oneself the hard way!

The reason I volunteer is to put my time and knowledge(I'm a pharmacist)to good use in order to help old people( all my patients are 70+ war veterans) in whatever way i can!Yet I find myself in this situation because of lack of basic common sense(not washing)and that is preventing from volunteering! Please answer my question as quickly as you can. I can barely type these words for shaking so much at the thought of what happened. Thank you so much for your quick response. PS. I have donated to many foundations and would love to donate to the AIDS foundation. Infact I read that you stay in Los Altos. I visit los altos every other month so maybe I will bump into you someday.

Response from Dr. Frascino

Hi,

Your HIV risk is essentially nonexistent. HIV cannot permeate intact skin. Your "tiny bumps" would not be a significant risk factor.

PEP is not warranted. Routine testing for a possible occupational exposure is the most that would be recommended.

I see no reason for concern or for you not to continue to volunteer your services. I would suggest you peruse the information in the archives and its related links that is related to occupational exposures to bloodborne pathogens. I'm confident you'll find that information reassuring.

Thanks for your donation (www.concertedeffort.org) and for your volunteer service. Both are warmly appreciated. In return I'm sending you my best good-luck/good-health karma that your follow-up HIV screening tests remain negative. I'm absolutely confident they indeed will.

Dr. Bob



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