Download Bloodborne Pathogens

Bloodborne
Pathogens
Protecting yourself from disease
What are bloodborne pathogens?
Disease causing microorganisms,
such as viruses, bacteria or
parasites that are carried in
human blood.
The Law
Certain jobs may involve contact with blood or
other body fluids
The U.S. Department of Labor’s Occupational
Safety and Health Administration ( OSHA)
issued regulations to protect employees from
bloodborne pathogens.
29 CFR 1910.1030 is the regulation number
• It was issued in 1991
The Law Cont.
These regulations require employers to use a
combination of engineering, work practice
controls, personal protective equipment,
medical surveillance and additional safety
precautions in the work place.
Any employees that are at risk from contact
with human blood are required to receive
training in bloodborne pathogens.
Reporting
• An occupational exposure incident occurs if
you are in a work situation and come in
contact with blood or body fluids.
• For OSHA 2000 record keeping purposes, an
occupational bloodborne pathogens exposure
incident such as , needle stick, laceration or
splash is classified as an injury because it is
usually the result of instantaneous event or
exposure.
Reporting
• After an exposure employees names are
placed on the OSHA 2000 log.
• The goal of reporting an exposure is to ensure
that an employee receives prompt access to
medical services and to identify and adopt
other methods or devices to prevent
exposures incidents from recurring.
Reporting
• The following should be included in the report
Date and time of incident
Job classification
Worksite location
Work practices being followed
Engineering practices in place including name or
brand of device such as sharps/ needles
PPE
Procedure being performed and training received
OSHA Expectations
The objective of the standard is to limit or
prevent exposure to blood or body fluids
however, exposure to a bloodborne may
occur.
If there is a risk of exposure or injury, it is
important for you to know the following:
There is a way to prevent infection as a result
of exposure to the pathogen, such as
immunizations
OSHA Expectations Continued
• The symptoms caused by infection with the
pathogen, as well as the natural course of the
infection
• Counseling specific to the exposure incident is
available
• The postexposure treatments and follow-up
that may be provided to you
• THE BOTTOM LINE EDUCATE YOURSELF!!!
The Ryan White act
• This public law – 101-381, Creates a
notification system for emergency response
employees listed as police, fire and EMS who
are exposed to diseases such as tuberculosis,
hepatitis B and C and HIV.
• The CDC is currently working a final list of
diseases that will be included in this law.
Mode of Transmission
• Bloodborne pathogens are transmitted when
blood or body fluids come in contact with
mucous membranes or nonintact skin ( cuts,
abrasions, burns, rashes, acne, papercuts, and hangnails).
• Transmission may occur from splashes or
sprays of blood,handling or touching
contaminated items or surfaces and injection
under the skin by puncture wounds or cuts
from contaminated sharps.
Modes of transmission
• Types
– Direct contact – organism is moved from one
person to another through touching.
– Indirect contact – infection is spread through
inanimate object ( needle stick)
– Airborne – spread through droplet or dust
– Food borne- spread through infected food or
water.
– Vector borne ( insects or parasitic worms)
CDC Recommendations
• ALL persons are potentially infected or can
spread an organism that could be transmitted
in the health care setting.
• Standard precautions must be used on all
patient encounters.
CDC Recommendations
• Hand Washing ( best way to prevent the
spread of disease)
 After touching blood or body fluids
 Immediately after removing gloves
 Between patient contacts
CDC Recommendations
• Personal Protective Equipment (PPE)
Gloves –
for touching blood or body fluids
for touching mucous membranes and
nonintact skin
Gowns-
CDC Recommendations
• Patient Care Environment
 Soiled patient care equipment
handle in a manor that prevents transfer of
microorganisms to others and to the environment
 Wear gloves if visibly contaminated
 Use proper hand hygiene
Environmental controls
 Have procedures for the routine cleaning and
disinfection of environmental surfaces
CDC Recommendations
 Environmental controls continued
Pay special attention to the frequently touched
surfaces with in the ambulance ( handrails, seats,
cabinets, doors)
 Textiles and laundry
Handle in a manor that will prevent the transfer of
microorganisms to others and to the environment
CDC Recommendations
 Needles and other sharp objects
Do not recap, bend, break, or hand-manipulate used
needles.
Use safety features when available ( needleless IV
systems)
Place sharps in puncture-resistant containers
CDC Recommendations
• Special Circumstances
Patient resuscitation
Use mouthpiece, resuscitation bag, or other
ventilation devices to prevent contact with
mouth and oral secretions.
Respiratory Hygiene/cough etiquette
Instruct symptomatic patients to cover their
mouth/nose when sneezing or coughing
Use tissues and dispose in no-touch
receptacles
CDC Recommendations
Respiratory Hygiene/cough etiquette continued
 Perform hand hygiene after touching tissues
 Place surgical mask on patient/provider
 If mask cannot be used, maintain special
separation (> 3’) if possible
Specific Bloodborne Pathogens
• Hepatitis Viruses – Inflammation of the liver
• Hepatitis A (HAV) – Good hygiene and proper
sanitation can help prevent hepatitis A. This
transmitted via fecal-oral route from
contaminated food and water.
• The time between infection and the
appearance of the symptoms is between two
and six weeks
• There is a vaccination for HAV
Hepatitis A (HAV)
• Hepatitis A does not have a chronic stage, is
not progressive, and does not cause
permanent liver damage. Following infection,
the immune system makes antibodies against
HAV that confer immunity against future
infection. The disease can be prevented by
vaccination, and hepatitis A vaccine has been
proven effective in controlling outbreaks
worldwide.
Hepatitis B (HBV)
• Hepatitis B (HBV) – There has been a decline in HBV in recent
years.
• Transmission of hepatitis B virus results from exposure to
infectious blood or body fluids.
• The acute illness causes liver inflammation, vomiting, jaundice
and—rarely—death. Chronic hepatitis B may eventually cause
liver cirrhosis and liver cancer—a fatal disease with very poor
response to current chemotherapy
• There is a vaccine available. The vaccine comes in series of
three shots.
Hepatitis B (HBV)
• There is a vaccine available. The vaccine
comes in series of three shots.
• Acute infection with hepatitis B virus is
associated with acute viral hepatitis – an
illness that begins with general ill-health, loss
of appetite, nausea, vomiting, body aches,
mild fever, dark urine, and then progresses to
development of jaundice.
Hepatitis B (HBV)
• It has been noted that itchy skin has been an
indication as a possible symptom of all
hepatitis virus types. The illness lasts for a few
weeks and then gradually improves in most
affected people. A few patients may have
more severe liver disease and may die as a
result of it. The infection may be entirely
asymptomatic and may go unrecognized.
Hepatitis C (HCV)
• Hepatitis C is an infectious disease affecting
the liver, caused by the hepatitis C virus (HCV).
The infection is often asymptomatic, but once
established, chronic infection can progress to
scarring of the liver (fibrosis), and advanced
scarring (cirrhosis) which is generally apparent
after many years. In some cases, those with
cirrhosis will go on to develop liver failure or
other complications of cirrhosis, including liver
cancer.
Hepatitis C (HCV)
• The hepatitis C virus is spread by blood-toblood contact. Most people have few, if any
symptoms after the initial infection, yet the
virus persists in the liver in about 85% of those
infected. Persistent infection can be treated
with medication, peginterferon and ribavirin
being the standard-of-care therapy. Fifty-one
percent are cured overall.
Hepatitis C (HCV)
50% not a large percentage.
PPE is essential!
Human immunodeficiency Virus
(HIV)
• HIV causes AIDS acquired immunodeficiency
syndrome.
• a condition in humans in which the immune
system begins to fail, leading to lifethreatening opportunistic infections. Infection
with HIV occurs by the transfer of blood,
semen, vaginal fluid, or breast milk. Within
these bodily fluids.
Human immunodeficiency Virus
(HIV)
• The four major routes of transmission are
unsafe sex, contaminated needles, breast
milk, and transmission from an infected
mother to her baby at birth (perinatal
transmission).
• That newborn may be infected. Treat ALL
people even infants as if they are infected.
Human immunodeficiency Virus
(HIV)
• Treatment with anti-retrovirals increases the
life expectancy of people infected with HIV.
Even after HIV has progressed to diagnosable
AIDS.
Human immunodeficiency Virus
(HIV)
• HIV infection has basically four stages:
incubation period, acute infection,
latency stage and AIDS. The initial
incubation period upon infection is
asymptomatic and usually lasts between
two and four weeks.
Human immunodeficiency Virus
(HIV)
• The second stage, acute infection, lasts
an average of 28 days and can include
symptoms such as fever,
lymphadenopathy (swollen lymph
nodes), pharyngitis (sore throat), rash,
myalgia (muscle pain), malaise, and
mouth and esophageal sores.
Human immunodeficiency Virus
(HIV)
• The latency stage, which occurs third, shows
few or no symptoms and can last anywhere
from two weeks to twenty years and beyond.
AIDS, the fourth and final stage of HIV
infection shows as symptoms.
Symptoms of Acute AIDS
Human immunodeficiency Virus
(HIV)
• In general, if infected blood
comes into contact with any open
wound, HIV may be transmitted.
Human immunodeficiency Virus
(HIV)
• Post-exposure follow up and prophylaxis
– There is no cure for HIV. All decisions about
laboratory testing and prophylaxis are made in
consultation with your health care professional.
– Testing for the HIV antibody should be done as
soon as possible after exposure and thereafter,
periodically for least 6 months. Antibodies usually
become detectable within 3 months of infection.
Human immunodeficiency Virus
(HIV)
• Post – exposure treatment should be made in
conjunction with a infectious disease
specialist.
• Post – exposure treatment is not
recommended for all occupational exposures.
99.7% of the exposures do not lead to HIV
infections.
• If treatment is recommended it should begin
within hours of the exposure.
Tuberculosis (TB)
• Tuberculosis usually attacks the lungs but can
also affect other parts of the body. It is spread
through the air, when people who have the
disease cough, sneeze, or spit. Most infections
in humans result in an asymptomatic, latent
infection, and about one in ten latent
infections eventually progresses to active
disease, which, if left untreated, kills more
than 50% of its victims.
Tuberculosis (TB)
• The classic symptoms are a
chronic cough with blood-tinged
sputum, fever, night sweats, and
weight loss. Infection of other
organs causes a wide range of
symptoms.
Tuberculosis (TB)
• Skin test are often used for routine screening
of high risk individuals.
• Interferon-γ release assays are blood tests
used in the diagnosis of some infectious
diseases. There are currently two interferon-γ
release assays available for the diagnosis of
tuberculosis:
Tuberculosis (TB)
Skin Test
Tuberculosis (TB)
• Treatment –
Treatment for TB uses antibiotics to kill the
bacteria. Effective TB treatment is difficult,
due to the unusual structure and chemical
composition of the mycobacterial cell wall,
which makes many antibiotics ineffective and
hinders the entry of drugs.
Tuberculosis (TB)
• The two antibiotics most commonly used are
rifampicin and isoniazid. However, instead of
the short course of antibiotics typically used
to cure other bacterial infections, TB requires
much longer periods of treatment (around 6
to 24 months) to entirely eliminate
mycobacteria from the body.[