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BLOOD BORNE PATHOGENS TRAINING SESSION
For Union University Employees

Union employees with a potential exposure to human blood and body fluids, in the course of their duties, are required to read the information in the link that follows and submit the completed test to the Director of Health Services. The graded test will be forwarded to Human Resources for placement in your file. If you score less than 80%, you will be required to take the test again. Additional resources are available from Health Service if you have any questions.

Blood Bourne Pathogen Training Module

Training Session Directions

1. Read the text information below
2. Watch the video on Blood Borne Pathogens
3. Complete the consent forms
4. Make appointment at the Health Clinic for the three series vaccinations. There is no charge for these vaccinations.

I.  A general explanation of the epidemiology and symptoms of HBV and HIV                                 

Explanation of the modes of transmission of HBV and HIV
“Blood borne pathogens” means any disease-causing organism that lives in and is transmitted through the blood.  The purpose of this training is for you as employees who might be exposed to blood borne pathogens to learn how you can protect yourself against these organisms.  The two main blood borne pathogens we are concerned with are hepatitis B and HIV (or human immunodeficiency virus).

We have all heard lots of things about HIV or AIDS.  You may not be as familiar with hepatitis B.  We are going to focus most of our attention on hepatitis B because that is the one for which a vaccine is available to prevent the disease.  There is no vaccine to prevent or cure HIV.  If you contract HIV, you will die from it.  But infection with both HIV and HBV can be avoided if you use reasonable caution, and that is why they are lumped together when we talk about blood borne pathogens.

My main discussion with you today is going to focus on hepatitis B and the vaccine to prevent it so that you can make an informed decision about taking the HBV vaccine.  I want to talk about HIV first and then go on to hepatitis B.

HIV (or human immunodeficiency virus) is the virus that causes AIDS.  We know a lot of things about HIV:

1. We know that HIV changes the genetic structure of the cell it attacks.

2. Researchers can produce HIV in the lab so they can study it more closely.

3. There is a test that is used to screen blood for HIV which makes blood transfusions safer.

What we don’t know about HIV is how to stop it once it is in the human body.  We know how to kill it outside the human body – household bleach will kill HIV.

Where is HIV found?  It is found in varying concentrations or amounts in human blood, semen, vaginal fluids, breast milk, saliva and tears.  It is important to understand that finding a small amount of HIV in a body fluid does not necessarily mean that HIV can be transmitted by that body fluid.  HIV has been found in saliva and tears of some patients with full-blown AIDS.  HIV has never been found in the sweat of infected patients.  Contact with saliva, tears or sweat has never been shown to result in transmission of HIV. Scientists and medical experts agree that HIV is such a fragile virus that it does not survive well in the environment.  It dies quickly outside the human body.  So you are unlikely to get HIV from a toilet seat.

How is HIV transmitted? Research shows HIV is spread mainly:

1. Through sexual intercourse

2. By sharing a needle with someone with HIV

3. From HIV infected mothers to babies

4. From blood products through transfusion.  This risk is almost entirely eliminated due to screening methods now used.

The only one of these modes of transmission that would apply to you in the workplace would be exposure to blood – and that would almost have to be someone bleeding directly into an open wound or broken skin or into your eyes or other mucous membranes.  Dried blood would not be a problem because the virus dies so quickly.

What are the symptoms of HIV? A person can be HIV positive for many years and have no symptoms at all.  They may look and feel healthy.  However, they can still pass the virus to others.  As the infection progresses, severe and lasting symptoms may be noticed:

1. swollen lymph glands in the neck, underarm or groin area

2. recurrent fever, including “night sweats”

3. rapid weight loss for no apparent reason

4. constant tiredness

5. diarrhea and decreased appetite

6. white spots or unusual blemishes in the mouth

In full-blown AIDS, the immune system is severely weakened, which allows normally mild or rare diseases to be fatal.  HIV is bad stuff.  There is no vaccine to prevent it and no cure for it.  Avoid any behaviors which might put you at risk for contracting HIV.

Now let’s focus our attention on hepatitis B which is the main thrust of this program today.

What is hepatitis B?  Hepatitis B is an infection of the liver caused by the hepatitis virus. One in twenty has been infected.  One hundred thousand new cases of hepatitis B infection occur yearly in the United States.  One million to one and a quarter million U.S. residents are chronic carriers of HBV.  Four thousand to five thousand people die each year of chronic liver disease caused by hepatitis B.

Those are pretty scary figures.  Let’s look at this chart and see what actually happens with hepatitis B.  50-67% of people who contract hepatitis B are asymptomatic or never know they have the disease – they may think they have the flu.  Of this group, 90-95% recover and have immunity to hepatitis B.  Some of you may even be immune to hepatitis B.  The other 5-10% become chronic carriers.  Of this group, 20-50% have persistent hepatitis and 25% have chronic active hepatitis B.  Of this group, 50% will develop cirrhosis of the liver, which leads to death.  20% of people with chronic active hepatitis develop liver cancer and die.

Of those people who become symptomatic with hepatitis B infection, ½ of 1% have what is called fulminant HBV, which causes death.  It is such an overwhelming infection that the body can’t overcome it.  The rest of these people fall into the categories of recovery and immunity (90-95%) or become chronic carriers (5-10%) that I mentioned earlier.

You can see that because of the numbers of people involved, hepatitis B is a major health problem.

What are the symptoms of hepatitis B?  Infection from the HBV may occur 6 weeks to 6 months after exposure to the virus.  Many people think they have the flu.  Signs include: tiredness, loss of appetite or weight, mild fever, aching joints and muscles, stomach pain, nausea and vomiting, and diarrhea.  Some people may also have dark urine and jaundice (about 25%), skin rashes and light-colored bowel movements.  Most people have a full recovery from hepatitis B within 6 months.

How is HBV transmitted?  Unlike HIV, which is a fragile virus and dies quickly, HBV is a very hardy virus that can live up to 1 month outside the human body.  One source said “up to 6 months.”  HBV is transmitted from one person to another through body fluids – mainly blood, semen and vaginal fluids, and to a lesser degree – saliva, urine, and feces.  It is not in sweat or tears.  HBV is spread by:

1. having sex with someone who is infected
2. sharing needle or personal items such as razors, toothbrushes or nail clippers with someone who is infected
3. tattooing, ear piercing or acupuncture if contaminated needles or equipment is used
4. infected mothers to babies
5. infected blood (or other body fluids) entering your body through a cut or broken skin.

HBV is not spread through casual contact or through the air.  You cannot get it by shaking hands, sitting next to someone, giving blood, eating food or drinking water.

II. Information on the hepatitis B vaccine

I’ve given you the bad news, now let’s get to the good news.  The good news is there is a vaccine that is up to 95% effective in preventing hepatitis B.  The vaccine is given in 3 doses over a period of 6 months.  You must have all 3 doses in order for the vaccine to be effective.  Among individuals who take the whole series and develop antibodies, effectiveness is virtually 100%.  The antibody level will in time decrease, but people with normal immune systems continue to be protected from infection.  The Centers for Disease Control does not recommend booster doses at this time.

The vaccine is not made from any human blood product.  There is not danger of getting hepatitis B from the vaccine.  The most common side effects of the vaccine are injection site soreness (22%) and fatigue (14%).  The following side effects have been reported in 1-10% of those injected:

1. local reaction at the site (induration, swelling or redness)
2. fever above 99.5
3. headache
4. dizziness

The vaccine is offered to you at no charge.  You are free to accept or decline the vaccination series.  If you decline but later decided you want the vaccine, you may still get it free of charge.

Whether or not you take the vaccine, it is very important that you follow procedures that will be related to you regarding protecting yourself from exposure to the HBV.  You can’t just say, “I’ve had the shots.  I won’t get hepatitis B.”  You must protect yourself from the exposure to the body fluids which transmit HBV and HIV.