Infectious Diseases, Bloodborne Pathogens, and Universal Precautions

How are bloodborne pathogens transmitted?

Bloodborn pathogens are transmitted through contact with blood or other bodily fluids

Which viruses are of serious concern?

Hepatitis, especially hepatitis B, and human immunodeficiency virus

What should be maintained in healthcare facilities?

Healthcare facilities must be maintained as clean and sterile to prevent the spread of disease and infection

Why should we take precautions?

Must take precautions to minimize risk

What is an infectious disease?

Invasion of a host (animal or person) by a microorganism (pathogen)

• Causes disease by disrupting vital body processes

• Stimulates the immune system to react defensively

What are examples of the immune response?

• Fever

• Inflammation

• Or other damaging symptoms

What are the most common pathogens?

Bacteria, viruses, parasites, or fungi

What is important to know about microorganisms?

They can live in host and be harmless until an agent and mode of transportation allows for transfer of microorganism called pathogens, which lead to infection

How can an infectious disease be contagious?

It is contagious if transmission occurs from one individual to another

What is direct vs. indirect transmission?

Entry into body through skin, respiratory system, digestive, or reproductive system

What are the 3 types of direct transmission?

1. Contact of body surfaces (touching and sexual intercourse)

2. Droplet spread (inhalation of air droplets; someone sneezes and you breathe it in)

3. Fecal-oral spread (feces on hands through contact with mouth

What are the 3 types of indirect transmission?

1. Inanimate object - water, food, towels, clothing, and utensils

2. Vectors - insects, birds, and animals

3. Airborne transmission - infected particles suspended in air: infected via sharing air supply

What does the ability to generate infection depend on?

• Acquired immunity

• Overall health

• Health-related behavior

What are the general stages of infection?

• Incubation stage

• Prodromal stage

• Acute stage

• Decline stage

• Recovery stage

What happens in the incubation stage for infection?

• From time pathogen enters body to time signs and symptoms of disease appear

• Lasting from few hours to months depending on concentration, virulence, level of immune response, and presence of other health problems

• Unaware something entered until the person starts to have signs and symptoms

What happens in the prodromal stage for infection?

• Watery eyes, runny nose, slight fever, and malaise may develop briefly

• Host can transfer pathogen to other hosts

• Host should be isolated to prevent transmission

What happens in the acute stage for infection?

• Disease reaches point of greatest development while body resists further damage from pathogen

What happens in the decline stage of infection?

• First signs of recovery

• Could relapse if patient becomes overextended

What happens in the recovery stage for infection?

• Overcome invading pathogen

• Patient remains susceptible

• Body may have built up immunity and will be resistant to further exposure (may not be permanent)

What are mechanical defenses?

Separates the internal body from the external environment

What are the mechanical defenses?

Skin, mucous membranes

What does the immune system do?

Eliminates microorganisms, foreign proteins, and antigens

What does the immune system consist of?

Consists of T cells and B cells

What do T cells and B cells do?

T cells: recognize the invaders

B cells: contain and ultimately destroy the invaders

Where are the T cells and B cells located?

Bloodstream, lymphatic tissues, and interstitial fluid

What do antigens trigger?

Antigens trigger leukocytes and macrophages to locate and destroy antigens

T cells facilitate what?

Macrophages

What are B cells transformed to?

Into specialized cells (plasma cells) capable of producing antibodies

What do antibodies neutralize and how?

Antibodies neutralize antigens via lysis and phagocytosis

Why are memory T cells formed?

Memory T cells are formed to record information regarding antigens and immune response

What is innate immunity?

Born with from our mother

What is acquired/adaptive immunity?

Adapted through memory T cells

• Developed in response to first time exposure to a pathogen

• OR developed artificially through vaccinations/immunizations or passively when antibodies are injected

• Both can provide projection against infectious disease

What diseases have vaccinations?

• Diphtheria

• Pertussis (whooping cough)

• Hepatitis B

• Hemophilus influenza type B

• Tetanus

• Rubella (German measles) and measles

• Polio, mumps, and chickenpox

• Covid

What is the point of immunizations?

Help to minimize incidence of childhood communicable diseases

How is epidemiology used?

Epidemiology is a tool used to study infectious disease in a population

What are the disease outbreak terms?

• Sporadic

• Endemic

• Epidemic

• Pandemic

What is a sporadic?

Occasional occurrence

Like the flu

What is an endemic?

Regular cases often occurring in a region

Like the measles break out that is happening right now (2026) or Ebola

What is an epidemic?

Unusually high number of cases in a region

What is a pandemic?

Global epidemic

Covid…

What is the most effective practice in preventing the spread of infectious disease?

Washing hands

How are super bugs formed?

Super bugs are formed when a patient stops taking their antibiotic before the antibiotic finished. This means the weaker invaders were destroyed and what was left are the stronger ones

Where do pathogenic organisms present in?

Pathogenic organisms present in human blood and other fluids (cerebrospinal fluid, semen, vaginal secretion, and synovial fluid) that can potentially cause disease

What are the most significant pathogens?

• Hepatitis B (HBV)

• Hepatitis C (HBC)

• Human immunodeficiency virus (HIV)

What is the mechanism of which virus reproduces?

1. The virus attaches to the host cell. The entire virus may enter the cell or it may simply inject its genetic material, or genome

2. The viral genome uses the host cell’s machinery to replicate again and again

3. Each new copy of the genome directs the cell to make it a protein shell

4. The new viruses emerge from the host cell capable of infecting other cells. In the process, the host cell is often destroyed

What is a virus?

• Submicroscopic parasitic organism that is dependent on nutrients within cell

• Strand of DNA or RNA dependent on metabolic and reproductive activity of cell

• Redirects cell activity to create more viruses

What is HBV?

Attacks liver, results in lifelong infection, cirrhosis, liver cancer, liver failure, and death

How does HBV spread?

Spreads when blood from infected person enters the body of someone who is not infected

• Unprotected sex, sharing needles

Is there a vaccination for HBV?

Yes

Individuals who have been vaccinated are at virtually no risk for infection

What are the signs and symptoms of HBV?

• Flulike symptoms like fatigue, weakness, nausea, abdominal pain, headache, fever, and possibly jaundice

Is there a possibility that someone with HBV does not show symptoms?

Yes

Antigen always present in these individuals

How many weeks may someone test positive for antigen of HBV?

2-6 erres of symptom development

What percentage of people recover within 6-8 weeks?

85%

What is the prevention for HBV?

• Good personal hygiene and avoiding high-risk activities

• Proceed with caution as HBV can survive in blood and fluids, in dried blood, and on contaminated surfaces for at least one week

How do we manage HBV?

• Vaccination against HBV should be provided by employer to those who may be exposed

• Athletic trainers and allied health professionals should be vaccinated

How many doses of the HBV vaccination are there and for how long?

Three dose vaccination over 6 months

What is the percentage of immunity in reference to which dose a patient receives?

After the second dose, 87% of those receiving vaccine will be immune and 96% after the third dose

What is HIV?

• A retrovirus that combines with host cell

• Infects T cells, B cells, and monocytes (macrophages)

What are the signs and symptoms of HIV?

• Transmitted by infected blood or other fluids

• Fatigue, weight loss, muscle or joint pain, pain or swollen glands, night sweats, and fever

When can antibodies be detected of HIV in blood tests?

Antibodies can be detected in blood tests within one year of exposure

How long could someone go before signs and symptoms develop?

8-10 years

Most that acquire HIV will develop what next?

Acquired immunodeficiency syndrome (AIDS)

What is AIDS?

• Collection of signs and symptoms that are recognized the effects of an infection

• No protection against the simplest infection

What is important to know about a positive test for HIV?

A positive test for HIV cannot predict when the individual will show symptoms of AIDS

Within how many years does someone have before they may die when they contract AIDS?

After contracting AIDS, people generally die within 2 years of symptoms developing

Is there a vaccine or a cure for HIV?

No, but there is drug therapy to help manage

What is the prevention for HIV?

• Greatest risk is through intimate sexual contact with infected partner

• Choose nonpromiscuous sex partners

• Latex condom provides barrier against HBV and HIV

• AVOID recreational drug use (needles)

What is the chance of athletes transmitting HIV?

Low

Is there risk of on-field transmission?

Minimal risk

Which sports have potential higher risk for transmission of AIDS of close contact and exposure to bodily fluids?

Martial arts, wrestling, and boxing

How do we protect the athlete from AIDS?

• Use mouthpieces in high-risk sports

• Shower immediately after practice or competition

• Athletes exposed to HIV or HBV should be evaluated and immunized against HBV

What are the policy regulations regarding AIDS?

• Athletes are subject to procedures and policies relative to transmission of bloodborne pathogen

• A number of sport professional organizations have established policies to prevent transmission

• Organizations have also developed educational programs concerning prevention and medical assistance

• Institutions should take responsibility to educate student athletes (and parents when applicable)

• Make athletes aware that greatest risk is involved in off-field activities

• Athletic trainer should take responsibility of educating and informing student athletic trainers of exposure and control policies

• Institutions should implement policies concerning bloodborne pathogens

• Follow universal precautions mandated by OSHA

Is there a definitive answer as to whether asymptomatic HIV carriers should participate in sport?

No

Which act says that athletes that are infected cannot be discriminated against and may only be excluded on medically sound basis?

Americans with Disabilities Act

What does the Americans with Disabilities Act cover?

• Must be based on objective medical evidence

• Also must take into consideration risk to patient and other participants and means to reduce risk

Can HIV tests for athletes be used as a screening tool?

No, should not be used

When may detectable antibodies appear following exposure?

May appear from three months to one year following exposure

When should testing occur for HIV?

Testing should occur at six weeks, three months, and one year

What administration established standards for employer to follow that govern occupational exposure to bloodborne pathogens?

Occupational Safety and Health Administration (OSHA)

What does OSHA cover to protect healthcare providers and patients?

• Responsibility of institution to protect athletic trainer

• Provide necessary supplies and education

• Athletic trainer has personal responsibility to follow guidelines

• Minimize risks by not eating/drinking, applying cosmetics/lip balm, handling contact lenses, and touching face before washing hands

How do we prepare the athlete?

• Prior to participation, all open wounds and lesions should be covered with dressing that will not allow for transmission

What dressing is best used to lessen the chance of cross contamination when dealing with a wound/lesion?

• Occlusive dressing

Which dressing would be considered a superior barrier when dealing with a wound or lesion?

• Hydrocolloid dressing

What do we do when bleeding occurs from the athlete?

• Athletes with active bleeding must be removed from participation and returned when deemed safe

• Bloody uniform must be removed or cleaned to remove infectivity

What are the person precautions an athletic trainer should take?

• Those in direct contact must use appropriate equipment

• Latex gloves, gowns, aprons, masks and shields, eye protection, and disposable mouthpieces for resuscitation

• Emergency kits should contain gloves, resuscitation masks, and towelettes for cleaning skin surfaces

What supplies and equipment must be available when dealing with biohazards?

• Nonlatex gloves

• Chlorine bleach

• Antiseptics

• Proper receptacles for soiled equipment/uniforms

• Wound care equipment

• Sharps container

What color are containers that contain potentially infectious material?

Red bags

What color are the labels on all biohazard warning equipment?

Fluorescent orange or red

What is the ratio of approved disinfectant to water used for cleaning contaminated surfaces?

1:10 ratio of approved disinfectant to water

What should disinfectant be able to do to HIV?

Should inactivate HIV

What should happen to towels when they become contaminated?

• Contaminated towels should be bagged, labeled, and separated from other soils laundry, and then transported in biohazard container

• Wash in hot water

• Laundry done outside institution should be OSHA certified

How hot should the water be when washing contaminated towels and for how long?

159.8˚F for 25 minutes

What belongs in sharps containers?

• Needles

• Razor blades

• Scalpels

What should we be aware of when handling/disposing of sharps?

• Use extreme care in handling and disposing of all sharps

• Do not recap, bend needles, or remove from syringe

• Scissors and tweezers should be sterilized and disinfected regularly

What happens when you close a sharps container?

They become closed permanently

Who are the OSHA guidelines designed for?

They are designed to protect coaches, athletic trainers, and other employees

Which person would not generally come into contact with blood and therefore risk is greatly reduced?

Coaches

How to protect athletes from exposure?

• Use mouthpieces in high-risk sports

• Shower immediately after practice or competition

• Athletes exposed to HIV or HBV should be evaluated and immunized against HBV

What are the post-exposure procedures?

• Athletic trainer should have confidential medical evaluation that documents exposure route, identification of source individual, blood test, counseling, and evaluation of reported illness

• Laws that pertain to reporting and notification of results relative to confidentiality vary from state to state

• Another reason why documentation of injuries is critical

  • Follow the trail