Transmission rates Hep C

[mykzhoe]

Hi--

Im a nurse who works in ER and through the nature of my work, I often am exposed to alot of blood. Recently, a light smear of blood from a Hep C pt touched m forearm where I had a healing contact dermatitis rash. I know the risk is low so im getting the series of testing done and not terribly worried.

My frusteration is in the blanket information told to me by doctors and online soures alike: "Hep C can be transmitted through non intact skin. Hep C pts usually carry high viral loads so even microscopic blood can transmit the virus." Or how about "its small it can transmit through gloves."  But when I do my own research, I see that, at least up until 2007, there has NEVER been a documented case of transmission through non intact skin. Yet everyone just goes around telling people you need to worry for the next 3 months because this is a high risk exposure.

Do you have the statistics on transmission through non intact skin? And if so, do they define nonintact skin? I have a hard time believing that it can easily be transmitted through "chapped skin" as they say in most literature. Thanks, I just want to be the one to have the FACTS when I share information like this with m patients and coworkers...

[lporterrn]

I wish I could help you in your desire to be an evidence-based nurse, but your own research has turned up all there is, a frustrating nothing. I have walked this tightrope too. There is no evidence - only "theoretical risk."  As a nurse who has hep C, I agonized whether I could be a nurse, enforcing my own "can't work with patients" when I had poison oak on hands.

Here's what we know: universal precautions work, since healthcare workers have about same HCV prevalence as general population. No evidence that HCV can be transmitted through gloves.

As for non-intact skin, that is a very broad catch-all warning, covering everything from the "theoretical" to the extreme. A war or disaster where military or first responders might encounter hazards and exposure to blood is obviously riskier than the situation you described.

Bottom line - You are right not to be worried - it is not a high risk, and it is questionable whether it is a risk at all. Be diligent in your follow-up to be 100% certain, but continue in refrain from catastrophizing until you have evidence to suggest otherwise. Good luck in educating others. Personally, I find it easier to educate others about HCV then I do about "not thinking the worst."