Bloodborne Pathogens ELCS Exam 2

Bloodborne pathogens

Pathogenic organisms that are present in human blood and can cause disease in humans

BBP include, but are not limited to...

HBV and HIV

Are BBP transmissible in a healthcare setting?

Yes

Routes of BBP transmission

Patient to provider

Provider to patient

Patient to patient

Cut/puncture with contaminated sharps

Splash into mucous membranes

Contamination of broken/non-intact skin

Risk of transmission differs based on:

Frequency of infection among patients

Type and frequency of blood contact

Infectious agent

Universal precautions

Approach to infection control where all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV, and BBP

Standard precautions

Minimum infection prevention practices that apply to all patient care

OPIM

other potential infectious material

Hepatitis

Inflammation of the liver

Types of inflammation of the liver

Infectious, alcoholic, drug induced, non-alcoholic fatty liver disease

What does the liver produce?

Cholesterol and bile

What does the liver store?

Macronutrients

What does the liver balance?

Blood sugar

Functions of the liver

Metabolism

Detoxification

Production of cholesterol

Storage of macronutrients

Blood sugar balance

Production of bile

Immune system

Protein synthesis

Types of hepatitis

A

B

C

D

E

Hepatitis A

Contaminated food or water

Hepatitis B

Contact with blood or OPIM

Hepatitis C

Contact with blood or OPIM

Hepatitis D

Contact with blood or OPIM

Hepatitis E

Contaminated food or water

To have hepatitis ______, you must also have hepatitis _____

D, B

How many hep B infected individuals have no symptoms?

30%

Symptoms of hepatitis B

Loss of appetite

Jaundice

Fever

Dark urine or pale poop

Nausea and vomiting

Pain in R abdomen

Joint pain

Hives

Headache

Weakness or fatigue

About 5% of hep B infected adults develop ________

Chronic infection

About 20% of those infected adults that develop chronic infection risk of dying from...

cirrhosis

About 6% of those infected adults that develop chronic infection risk of dying from...

liver cancer

The hep B virus can live on a surface for how long?

1 week

_______% risk of percutaneous exposure - hep B

30

What have reduced the incidence of hep B disease?

Standard precautions and vaccination

What types of treatments are available for hep B?

Antiviral meds and immune modulators

What percent of hep C infected individuals show no symptoms?

80%

What percent of hep C infected individuals develop chronic infection?

75-85%

About 70% of those infected adults that develop chronic infection from hep C risk of dying from...

liver disease

About 10-20% of those infected adults that develop chronic infection from hep C risk of dying from...

cirrhosis

About 1-5% of those infected adults that develop chronic infection from hep C risk of dying from...

liver cancer

How long can the hep C virus live on a dry surface?

6 weeks

What group accounts for 75% of hep C infections?

baby boomers

What is the risk of hep C from percutaneous exposure?

2%

Is there a higher risk of hep B or hep C mucous membrane or contact exposure?

hep B

Is there a vaccine for hep C?

no

What is the treatment for hep C?

direct acting antiviral medications (DAAs)

When did HIV/AIDS emerge?

1980s

What does HIV/AIDS do?

disables the immune system

What individuals are at a higher risk for opportunistic infections?

immunocompromised

Acute symptoms

develop suddenly and are typically more responsive to treatment

Symptoms of HIV and AIDS

acute (within 6 months) flu-like symptoms, night sweats, mouth sores, rash, swollen lymph nodes, yeast infections

Without treatment, HIV will progress to AIDS in how long?

8-10 years

AIDS

acquired immune deficiency syndrome

HIV

human immunodeficiency virus

Normal range of CD4 cells

500-1500

CD4 cell count for AIDS

less than 200

Can AIDS live on surfaces?

no

Where is the only place AIDS virus can survive?

inside body

What is the risk of AIDS via percutaneous exposure?

0.3%

Risk of AIDS via mucous membrane or contact exposure?

0.09%

Is there a vaccination for AIDS?

no

Treatment for AIDS

antiretroviral drugs (ARVs)

Post-exposure prophylaxis (PEP)

use of ARV drugs within 72 hours of exposure to HIV in order to prevent infection

When is PEP often recommended?

following needle stick injuries in the workplace

When is ARV needed to be started for it to be effective in PEP?

within two hours

Where are the eyewash stations located for bays:

1-4

5-8

first floor

back of bay

front corner of bay

back of bay

How long do you let the eyewash station run?

15 minutes

What is the % chance HBV, HCV, and HIV develop from a sharps injury?

HBV- 30%

HCV- 2%

HIV- 0.3%

How long does HBV, HCV, and HIV live on surfaces?

HBV- 1 week

HCV- 6 weeks

HIV- does not live outside of body

Is there a vaccine for HBV, HCV, or HIV?

HBV- yes

HCV and HIV- no

Disease transmission chain of infection

agent

reservoir

place of exit

mode of transmission

place of entry

susceptible host

loops back around

Modes of disease transmission

direct contact

indirect contact (contamination surfaces)

mucosal contact (absorption through direct contact)

inhalation

OSHA

Occupational Safety and Health Administration

What does OSHA do?

protects employees

Vaccination

prevents disease or lessens the severity of symptoms

Herd immunity

resistance to the spread of an infectious disease within a population that is based on pre-existing immunity of a high proportion of individuals as a result of previous infection or vaccination

Important vaccines among DHCP are...

hep B and HPV

It is required to offer ____________ vaccine and titer to employees at no cost

hep B

How many doses of hep B vaccine?

3 - No booster required

When do you test for adequate antibodies to hep B?

1-2 months after the 3 month series

If there is an inadequate response to the antibodies test for hep B, a retest is done. ____________% will now have antibodies. Those who do not have antibodies are considered _________________

50, susceptible

HBsAg

hepatitis B surface antigen

What does HBsAg indicate?

Active HBV infection

What is HBsAg used to make?

the vaccine

Anti-HBs

antibody to hepatitis B surface antigen

What does anti-HBs indicate?

recovery from infection or immunization to Hep B OR successful vaccination

Anti-HBc

total antibody to hepatitis B core antigen

What does anti-HBc indicate?

Previous or ongoing hepatitis B infection

Is anti-HBc seen with vaccination?

no

IgM anti-HBc

IgM antibody to hepatitis B core antigen

What does IgM anti-HBc indicate?

recent and acute infection

How many types of HPV?

over 40

Non-oncogenic vs oncogenic HPV

non-oncogenic - wart causing

oncogenic - cancer causing

About ___________ of people will get an HPV infection in their lifetime

85%

Each year in the US, HPV causes how many cancer cases in women and men?

36,000

HPV vaccination can prevent over __________% of cancers caused by HPV

90

When are the two doses of HPV given?

can start at 9 y/o, but is recommended at 11-12 years old

second dose is 6-12 months after the first

If you start the HPV vaccine in a child younger than 15 yo you give how many doses?

2

If you start the HPV vaccine in a child older than 15 yo you give how many doses

3

High risk types of HPV?

Types 16 and 18