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Klarinet Archive - Posting 000195.txt from 1999/01

From: "Diane Karius, Ph.D." <dikarius@-----.edu>
Subj: RE: [kl] HIV via saliva
Date: Wed, 6 Jan 1999 15:59:02 -0500

Neil wrote:
> It's interesting that you mention an accidental needlestick. There is
> a frightening story circulating via email about a woman who went to
> a movie theater, sat down in her chair, and felt something sharp. I don't know if this story
> is true, but the description suggests the conditions of an accidental
> needlestick. Would this woman be among your cited 0.2 - 0.3%
> infection rate?

It depends on a couple of things. If the contents of the syringe
were actually injected (rather than simply the contents of the needle
itself, which is what most needlesticks give you), her risk would be
considerably higher than those numbers cited (more blood = more
virus= greater possibility that it could establish itself in the
body). If the blood were from certain research sources (not simply
from someone infected with the virus) there might be considerably
more risk because the blood used in research labs may have been
specially concentrated with the lymphocytes infected with the virus
(accidental needlesticks with HIV-doped blood in research settings
initially accounted for the very high transmission rates reported in
the early days of the United States epidemic - those researchers had
virtually a 100% transmission rate). Luckily we have become much
better at isolating the virus (as well as having moved on to the more
specific research questions) and such HIV-doped blood is not commonly
used in research labs studying the disease/virus so the chance is
slim that that was an issue (this would have been detectable with
current testing). On the flip side, the current preventative
treatments are reducing the already low transmission rate even lower.

> So what you're saying is that while HIV is not a major concern, there
> are other diseases more easily transmitted via saliva about which we
> have good reason to be concerned when it comes to playing somebody
> else's clarinet setup. It's bad enough to catch somebody else's cold.
> I'd hate to unwittingly catch hepatitis from a student who failed to warn
> me of a recent illness.
>
Yes, in short. You're at greatest risk for any virus that is spread
preferentially via the saliva. (Although any of them are,
including HIV, dealt with effectively by using standard
disinfection techniques - the CDC approved standard is a 10%
bleach solution (and even weaker is being proposed), although the
standard high alcohol preps are okay (anything that washes away the
saliva is going to do just fine - the virus won't find anything on a
mouthpiece to "infect", so they'll wash away just fine)). Any virus
that finds its way into the saliva may also cause infection, but
there the risk is usually proportional to its concentration in the
blood.

To deal with hepatitis specifically (since I don't want to scare
anyone unnecessarily): You're not likely to run into a student who
is unaware of a recent bout with Hepatitis B. Hepatitis C may
not produce significant initial illness (it's a relative new comer -
it was first isolated in 1989 - 1990 and we were first able to test
for it in 1992 (or late 1991). It is now recognized as the leading
cause of end-stage liver disease in the United States (NOT counting
alcohol, of course). Since the risk factors are basically the same
for HIV (except for a higher viral load in the blood), I believe it
too can find its way into the saliva. The good news is since most
transmission (in the U.S.) is believed to be due to blood
transfusions or sexual transmission (standard exchange of blood and
bodily fluids), you are not likely to run into too many U.S. students
with that particular virus.

Sorry for the length of the reply - I'm being verbose today.
Diane R. Karius, Ph.D.
Department of Physiology
University of Health Sciences
1750 Independence Ave.
Kansas City, MO 641o6-1453
email: dikarius@-----.EDU

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