114 The efficiency of virus transmission after a single contact with infected
fluid tissue The nature and frequency of occupational blood contact
The concentration of the virus in the blood.
Occupations at greater risk include health care and emergency service personnel as well as those who travel and work in countries which have high
prevalence of the illness.
Protection comes from avoidance of blood to blood contact by precautions including:
Wearing protective gloves and face masks Covering cuts and wounds with a waterproof dressing
Care with sharps Ensuring all equipment is appropriately sterilized
Safe disposal of infected material Control of surface contamination
Good hygiene When appropriate, immunisation of „at risk‟ workers e.g. hepatitis B.
12.3.1 Hepatitis B
Hepatitis B is a blood-borne and sexually transmitted virus which causes inflammation of the liver. Many infected people have no symptoms, but others
have a flu-like illness with nausea and jaundice. Hepatitis B can cause hepatitis inflammation of the liver and can also cause long term liver
damage. Hepatitis B is more common in parts of the world such as south-east Asia,
Africa, the middle and Far East and southern and eastern Europe. WHO estimates that there are 350 million chronically infected people world-wide.
The virus may be transmitted by contact with infected blood or body fluids from an infected person. The failure to clear hepatitis B infection after six
months leads to the chronic carrier state. Many people who become chronic carriers have no symptoms and are unaware that they are infected.
115 General precautions include protecting against blood to blood contact. In
addition all healthcare workers should be immunised against hepatitis B infection and should be shown to have made a serological response to the
vaccine. Universal precautions should be adhered to in the hospital setting. 12.3.2 Hepatitis C
Hepatitis C is a blood-borne virus which causes inflammation of the liver. There is no vaccine available to prevent hepatitis C infection. Hepatitis C
infection affects different people in different ways; many experience no symptoms at all while others experience extreme tiredness. Reported
symptoms include fatigue, weight loss, nausea, flu like symptoms, problems concentrating, abdominal pain and jaundice.
It is estimated that around 15-20 of infected people clear their infections naturally within the first 6 months of infection. For the remainder, hepatitis C is
a chronic infection that can span several decades and can be life-long In the 80-85 of individuals who fail to clear their infections naturally, the
outcome of infection is extremely variable. Many people never develop any signs or symptoms of liver disease in their lifetime, and may not even know
that they have been infected. Other people go on to develop serious liver disease.
The World Health Organisation estimates that there are 170 million carriers of hepatitis C worldwide. The virus is spread when blood from an infected
person gets into the bloodstream of another. Prevention is centred on stopping the blood from infected individuals from coming into contact with
others. Injecting drug users are at high risk of infection, sterile injecting equipment
should always be used. In a health care setting, universal precautions should be adhered to; all blood and body fluids should be treated as potentially
infectious at all times.
116
12.3.3 HIV - Human Immuno-deficiency Virus
