b. Body Fluids. Fluids that have been recognized by the Centers for Disease
Control as directly linked to the transmission of HIV, HBV, and to which universal
precautions apply are blood, semen, vaginal secretions, cerebrospinal fluid, synovial
fluid, pericardial and amniotic fluids, and concentrated HIV or HBV viruses. Body fluids
are also referred to as OPIM.
1-11. BLOODBORNE PATHOGENS: HUMAN IMMUNODEFICIENCY VIRUS AND
HEPATITIS B VIRUS
a. Epidemiology.
(1) Approximately eight to ten million persons are thought to be infected with
HIV world-wide. The incubation period is still unknown. Early symptoms are fatigue,
low-grade fever, and general malaise.
(2) Less than five percent of the United States (US) population is reported to
be HBV positive. The incubation period is usually 60--90 days with a range of 30--180
days; however, some cases have been reported ten years after initial exposure. HBV
may be asymptomatic, detected through serologic tests. Early symptoms may be flu-
like, nausea and vomiting, fatigue, and mild liver enlargement. Late symptoms include
darkening urine, light-colored stool, jaundice, anorexia, and itching.
b. Transmission.
(1) For soldiers working in the health care environment, the most common
means of exposure to bloodborne pathogens is through accidental needle-stick with
contaminated blood or other body fluids.
(2) The second most common means of exposure in the workplace is
contact by an open wound or non-intact skin (chapped or abraded skin) of a health care
worker to contaminated blood, other body fluids, or concentrated virus.
(3) In the community, the most common means of transmission of HIV and
HBV is through contaminated body fluids during sexual activity, especially semen and
vaginal secretions.
c. Prevention.
(1) Universal precautions prevent health care workers from coming into
contact with blood and other body fluids of patients. These precautions are methods of
infection control in which all human blood and certain body fluids are treated as if known
to be infectious for HIV, HBV, and other bloodborne pathogens. If there is any doubt, all
body fluids are to be considered potentially infectious.
(2) There is a Hepatitis B vaccination available to all health care providers
who have occupational exposure to bloodborne pathogens. Vaccinations consist of a
series of three inoculations over a six-month period. The vaccine is safe and effective,
and it protects for up to five to seven years after the first inoculation.
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