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Hepatitis C
General information
Hepatitis C is a serious disease of the liver caused by a virus. Hepatitis
means inflammation of the liver. Sometimes, it can be brought on by alcohol
or drugs, but usually it is caused by a virus. There are several different
types of virus known to cause hepatitis. One virus causing increasing
concern amongst Health Professionals is Hepatitis C, which is a blood
borne virus. The incubation period, from exposure to the virus until the
onset of the disease is one to six months. Symptoms of Hepatitis C vary
considerably from flu like symptoms to an acute illness with abdominal
pain and jaundice. Many will be unaware that they have sustained the infection.
The consequences of hepatitis infection vary from one individual to another,
these can include, chronic liver disease, cancer of the liver, and, in
severe cases, death. Twenty percent of people will clear the virus at
the acute stage, the remaining eighty percent will remain infected. This
carrier state can persist for many years.
Hepatitis C is transmitted via blood and other body fluids. The most common
cause of transmission in Health Care Workers is via needle stick injury
or blood splashes to mucous membrane. Cuts and skin lesions can also provide
a portal of entry. Hepatitis C is spread in the general population through
sharing contaminated equipment for drug injection. Sexual transmission
is possible but unusual. Infection may also have been acquired from receipt
of unscreened blood or untreated plasma products (in the UK prior to September
1991 for blood, and 1985 for plasma).
The spread of Hepatitis C can be prevented amongst Health Care Workers
by good practice and adoption of ‘Universal Precautions’,
a system of good practice regardless of whether the situation is considered
high risk or not.
The Department of Health issued new guidance in August 2002 ‘ Hepatitis
C Infected Healthcare Workers’ http://www.doh.gov.uk/hepatitisc.
The aim of the guidance is to prevent the transmission of Hepatitis C
from Health Care Workers to patients. The guidance only applies to Health
Care Workers involved in ‘exposure prone procedures’.
EXPOSURE PRONE PROCEDURES (EPPs) are defined as:-
Invasive procedures where there is a risk that injury to the health care
worker may result in the exposure of the patient’s open tissue to
the blood of the worker. They include procedures where the worker’s
gloved hand may be in contact with sharp instruments, needle tips or sharp
tissue (e.g. spicules of bone or teeth) inside a patient’s open
body cavity, wound or confined anatomical space, where the hands or fingertips
may not be completely visible at all times. (DOH Dec. 2002)
Health Care Workers who are intending to undertake professional training
for a career that relies upon the performance of exposure prone procedures
will be tested for antibodies to the Hepatitis C Virus on entry to HYMS and, if positive, for Hepatitis C virus RNA.
Anyone found to be Hepatitis C antibody positive will be recalled to the
Occupational Health Unit for advice and further testing. A positive test
would indicate a history of Hepatitis C infection.
A positive result would prevent commencement of areas of training involving
EPPs until further tests and treatment had been implemented. Refusal to
undergo testing would be treated as a positive result.
DOH guidelines are still under review, you will be informed of any changes.
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