Know different problems faced by health care workers who are either carriers or get exposed to different Bacteria/viruses.

Explanation

The discussion will focus on HIV  & HBV exposure, Meningococcal exposure, Needlestick injury, MRSA & VRE carrier states.

All of us should be immunized against Hepatitis B.

HIV does not preclude a doctor or nurse to discontinue their job.

A needlestick injury must be carefully evaluated. If a needle contaminated with a patient,s body fluid enters a healthcare worker, the employer is responsible for all the expenses. Anti HIV medications MUST be offered within 4 hours. SOLID needles (eg lance for accucheck) have not been shown to transmit HIV. At least 2 anti HIV drugs should be offered. If the source patient has been on Zidovudine, the victim should also be offered a 3rd anti HIV drug as well. These should be taken for 1 month & victim to be sexually protective for 6 months. The source & patient needs to be checked immediately and in 6 weeks, 12 wks & 6 mo- and the source patient has no right to refuse but we generally get a consent form signed.

There was recently a question on the risk of HIV transmission - it is 1 in 200 encounters. The risk of Hepatitis B on the other hand is 1 in 20 encounters. This is also called the transmission rate.

Meningococcal prophylaxis must be given to close contacts of the patient with meningococcal meningitis. The drug of choice is Rifampin for 2 days. A good alternative is Ciprofloxacin - single dose but this cannot be given to patients under the age of 17.

MRSA & VRE carriage states are no longer of any isolation benefit. Mupirocin cream is good for MRSA eradication from the nostril.