Bloodborne Pathogens

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Bloodborne Pathogens

• The University of Southern Mississippi
• School of Human Performance and Recreation
• Athletic Training Education Program

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Introduction

• How does a virus reproduce?
• Bloodborne pathogens
• Types
• Modes of transmission
• Prevention
• Management
• Signs and symptoms
• Bloodborne pathogens in athletics
• Universal precautions
• Watch video on bloodborne pathogens

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Virus Reproduction

• A virus is a submicroscopic parasite organism
• Dependent upon nutrients in cells
• Consists of DNA or RNA
• Make cells ill by redirecting cellular activity
• Steps
• Virus attaches to host cell may attach or inject
  genome
• Uses host cell to replicate other virus
• New copy of genome directs cell to make a protein
  shell
• New viruses emerge from host cell capable of
  infecting and destroying other cells, including
  the host cell

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Bloodborne Pathogens

• Pathogenic microorganisms that cause disease
• Present in human blood and other body fluids
• Semen
• Vaginal secretions
• CSF
• Synovial fluid
• HIV and HBV most prevalent pathogens
• HBV has higher potential for spreading disease

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Bloodborne Pathogens (cont)

• Two Main Types in Healthcare Settings
• HIV (Human Immunodeficiency Virus)
• HBV (Hepatitis B Virus)
• Other Types
• Hepatitis A, C, D
• Syphilis

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Hepatitis B Virus (HBV)

• Major cause of viral infection
• 200 deaths/year in healthcare settings
• 300,000 new cases/year
• Signs/Symptoms
• Flu-like (fatigue, weakness, nausea, abdominal
  pain, headache, fever, jaundice)
• Passive carrier?
• Positive test within 2-6 weeks after infection
• Mode of transmission (direct and indirect)

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Hepatitis B Virus (cont)

• Prevention
• Good personal hygiene
• Avoid high-risk activities
• Avoid contact with bodily fluids
• Management
• Vaccination at no cost to employee
• Given in three doses over six-month period

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Human Immunodeficiency Virus (HIV)

• HIV is a retrovirus
• Combines with a host cell and decreases their
  effectiveness (wearing down)
• T4 blood cells, macrophages
• 1 in 250 (est.) are infected (U.S. citizens)
• 1 of 100 adult males (20-49y) are HIV positive
• 40-50K new cases/year
• Person does not die from HIV dies from sequelae
  of events

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HIV (cont)

• Signs and Symptoms
• Fatigue, weight loss, muscle/joint pain, painful
  or swollen glands, night sweats, fever
• Antibodies detected in blood test within one year
  after exposure
• Silent carrier
• Mode of transmission (direct and indirect)

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Acquired Immunodeficiency Syndrome (AIDS)

• Collection of signs and symptoms
• Person has no protection against the simplest
  infections
• Vulnerable to contracting numerous diseases
• Disease of the 1990s
• 641,086 Americans have AIDS as of 12/97
• 385,000 have died
• Positive test cannot determine AIDS
• Approx. 50 contract AIDS within 10y of exposure

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AIDS (cont)

• Management
• No vaccine available, but drug therapy can extend
  life
• Most effective treatment to date is a combination
  of three drugs
• Prevention
• Avoid unprotected sexual contact
• Avoid contact with bodily fluids
• Avoid contact with known HIV carriers
• Avoid sharing needles

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Bloodborne Pathogens in Athletics

• HIV transmission risk is low
• No validated reports of transmission in sports
• Risk levels of various sports
• HIGH (Boxing, martial arts, wrestling, rugby)
• MODERATE (Basketball, football, ice hockey,
  soccer, team handball)
• LOW (golf, fencing, gymnastics, track/field,
  swimming, volleyball, weight lifting, badminton,
  bowling, cycling, etc.)

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Policy Regulation

• Professional organizations have developed
  policies and procedures to help prevent
  transmission of pathogens
• KEY COMPONENTS TO PREVENTION
• Education
• Adhering to policies and procedures

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HIV in Athletics

• Should asymptomatic HIV carriers be allowed to
  participate in sports?
• Can we test for HIV in athletes?
• NO, however we can encourage athletes to be
  tested.
• Still confidential and do not have to inform ATs
  or team
• TESTS USED TO DETERMINE HIV
• ELISA
• Western blot

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Universal Precautions

• OSHA (Occupational Safety and Health
  Administration)
• In 1991 established a bloodborne pathogen
  performance standard
• Designed to protect the employee, employers, and
  clients
• Colleges not held accountable at this time (not
  under federal guidelines)
• NATA has a position statement on bloodborne
  pathogens

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Universal Precautions (cont)

• Prepare the athlete
• Close all open wounds
• When bleeding occurs
• Must be removed from field and cleaned
• PPE (personal protective equipment)
• Gloves, mask, gowns, eye shields, cleanup
  equipment
• Supplies and Equipment
• Disenfectants, sharps containers

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Universal Precautions (cont)

• Remember that the goals of universal precautions
  are to protect
• Yourself (the healthcare provider)
• Athlete
• Post-exposure Procedures
• Report any incident
• Medical evaluation and testing
• Counseling

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Conclusions and Discussion