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dangerous to work at a hospital?
Jul 16, 1997

A guy in my support group who is back from death's door and thriving is going back to school this fall--nursing school. He was talking yesterday about his fear of picking up something bad (a disease, I mean) at his future place of employment. Is this a legitimate fear? Last summer he was down with the crypyo-coccyl meningitis. This guy is a living advertisement for the Crix Cocktail and mental fortitude. He doesnt have computer access so Im writing for him.

Response from Dr. Cohen

While most HIV-associated infections are not transmitted from person-to-person, there are a few that could be transmitted from a patient to an HIV-positive health care worker. The most serious is tuberculosis (especially multi-drug resistant tuberculosis, which is especially dangerous for immunosuppressed people). This could also be a problem for people working in places like homeless shelters, food kitchens, etc.

Cryptosporidiosis, a diarrheal infection, can also be transmitted from person-to-person, but requires much closer contact than does TB.

While varicella zoster, the cause of chicken pox and shingles, can be transmitted to hospital workers, most HIV-infected people are already infected with that virus, so it's rarely an issue. If you're not sure whether you've had it, an anti-varicella IgG test will tell you. If it's positive, you should be immune. If it's negative, you should avoid exposure to people with chicken pox or shingles, and consider getting varicella zoster immune globulin (VZIG) if you are exposed.

Anyone (HIV-positive or not) who works in direct patient care should be vaccinated against hepatitis B if they're not already immune. The vaccine against hepatitis A wouldn't hurt either.

Cryptococcal meningitis is not an infection that would be transmitted from person-to-person.



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