Blood-borne disease

"Blood borne" redirects here. For the video game, see Bloodborne.

Bloodborne disease

A clandestine kit containing materials to inject drugs, a bottle of a type of lean, promethazine, an antiemetic, and unidentified pills. Improper or reckless drug injection is one of the main risks of blood-borne diseases.
Specialty| Hematology, infectious disease
Contaminated currency such as banknotes frequently used for snorting may spread hepatitis C.[1]

A blood-borne disease is a disease that can be spread through contamination by blood and other body fluids. Blood can contain pathogens of various types, chief among which are microorganisms, like bacteria and parasites, and non-living infectious agents such as viruses. Three blood-borne pathogens in particular, all viruses, are cited as of primary concern to health workers by the CDC-NIOSH: human immunodeficiency virus, hepatitis B, and hepatitis C.[2]

Diseases that are not usually transmitted directly by blood contact, but rather by insect or other vector, are more usefully classified as vector-borne disease, even though the causative agent can be found in blood. Vector-borne diseases include West Nile virus, zika fever and malaria.

Many blood-borne diseases can also be contracted by other means, including high-risk sexual behavior or intravenous drug use. These diseases have also been identified in sports medicine.[3]

Since it is difficult to determine what pathogens any given sample of blood contains, and some blood-borne diseases are lethal, standard medical practice regards all blood (and any body fluid) as potentially infectious. "Blood and body fluid precautions" are a type of infection control practice that seeks to minimize this sort of disease transmission.

## Contents

* 1 Global epidemiology and statistics
* 2 Emerging blood-borne pathogens
* 3 Transmission routes
* 4 Occupational exposure
* 5 Advances in detection and prevention
* 6 Blood transfusions
* 7 Needle exchange programs
* 8 Prevention
* 9 Post-exposure protocol
* 10 See also
* 11 References

## Global epidemiology and statistics

Blood-borne diseases pose significant global health challenges, especially in regions with limited healthcare access. Recent Statistics include:

* HIV/AIDS: as of 2023, approximately 39.9 million people globally were living with HIV infection in 2023.[4]
* Hepatitis B: 2.4 million people are chronically infected in United States.[5]
* Hepatitis C: approximately 50 million people are infected with hepatitis C worldwide, with about 1 million new infections annually.[6]Template:AI-retrieved source

## Emerging blood-borne pathogens

While well-known blood-borne diseases such as human immunodeficiency virus, hepatitis B, and hepatitis C continue to be of major concern, new and emerging pathogens are also being identified. These include:

1. Zika Virus – although primarily transmitted by mosquitoes, Zika virus has been detected in blood transfusions, raising concerns about its potential as a blood-borne pathogen. [citation needed]
2. Ebola Virus – the Ebola virus can be transmitted through blood and bodily fluids, particularly in healthcare settings. Studies suggest that survivors may carry the virus for months.[citation needed]
3. Babesia microti – a parasite causing babesiosis, which is transmitted via tick bites but has also been found in blood transfusions, leading to increased screening measures.[citation needed]
4. HTLV-1 (Human T-lymphotropic virus type 1) – a retrovirus that affects white blood cells and is linked to adult T-cell leukemia, myelopathy, and other neurological disorders.[7]Template:AI-retrieved source

## Transmission routes

* Percutaneous exposure: Injuries from needlesticks or cuts with contaminated sharp instruments.[8]
* Mucous membrane exposure: Contact of mucous membranes with infected blood or body fluids.[9]
* Non-intact skin exposure: Blood contact with broken skin.[citation needed]

## Occupational exposure

Blood poses the greatest threat to health in a laboratory or clinical setting due to needlestick injuries (e.g., lack of proper needle disposal techniques and/or safety syringes). Needles are not the only issue, as direct splashes of blood also cause transmission.[10] These risks are greatest among healthcare workers, including: nurses, surgeons, laboratory assistants, doctors, phlebotomists, and laboratory technicians.[11] These roles often require the use of syringes for blood draws or to administer medications.[12]

The Occupational Safety and Health Administration (OSHA) prescribes 5 rules that are required for a healthcare facility to follow in order to reduce the risk of employee exposure to blood-borne pathogens. They are:[13]

* Written exposure control plan
* Engineering controls (Sharps containers, detachable and retractable needles, syringe caps, etc.)
* Safe work practices and safety devices
* Vaccines available to employees
* Education and post-exposure follow up

These controls, while general, serve to greatly reduce the incidence of blood-borne disease transmission in occupational settings of healthcare workers.[citation needed]

HVB vaccine

There are 26 different viruses that have been shown to present in healthcare workers as a result of occupational exposure. The most common blood-borne diseases are hepatitis B, hepatitis C, and human immunodeficiency virus.[14] Exposure is possible through blood of an infected patient splashing onto mucous membranes; however, the greatest exposure risk was shown to occur during percutaneous injections performed for vascular access. These include blood draws, as well as catheter placement, as both typically use hollow bore needles.[11] Preventive measures for occupational exposure include standard precautions (hand washing, sharp disposal containers), as well as additional education. Advancements in the design of safety engineered devices have played a significant role in decreasing rates of occupational exposure to blood-borne disease.[14] According to the Massachusetts Sharps Injury Surveillance System, needle devices without safety features accounted for 53% of the 2010 reported sharps injuries.[15] Safer sharps devices now have engineering controls, such as a protective shield over the needle, and sharps containers that have helped to decrease this statistic. These safer alternatives are highly effective in substantially reducing injuries. For instance, almost 83% of injuries from hollow bore needles can be prevented with the use of safer sharps devices.[16] There have been reports of HCW transferring disease to patients. This happens usually when surgeons perform using these sharps as well.[10]

## Advances in detection and prevention

Recent innovations in biomedical technology have significantly improved the early detection and prevention of blood-borne pathogens. One such advancement is Next-Generation Sequencing (NGS),[17] a high-throughput genomic sequencing technique that allows for the precise identification of pathogens at the molecular level, even in asymptomatic individuals. In addition, Point-of-Care Testing (POCT) [18] has revolutionized screening accessibility by enabling rapid diagnostic tests for infections such as HIV and hepatitis C, delivering accurate results within minutes, particularly beneficial in remote or resource-limited settings. Emerging CRISPR [19] based diagnostics are also showing promise. These utilize gene-editing technology to detect viral RNA in blood samples with high sensitivity and specificity, offering potential for rapid and cost effective pathogen identification. Furthermore, Universal Pathogen Inactivation [20] methods are being developed to neutralize a broad range of viruses and bacteria in donated blood, significantly lowering the risk of transfusion transmitted infections.

## Blood transfusions

Blood draw

Blood for blood transfusion is screened for many blood-borne diseases. Additionally, a technique that uses a combination of riboflavin and UV light[21] to inhibit the replication of these pathogens by altering their nucleic acids can be used to treat blood components prior to their transfusion, and can reduce the risk of disease transmission.

A technology using the synthetic psoralen (amotosalen HCl) [22] and UVA light (320–400 nm) has been implemented in European blood centers for the treatment of platelet and plasma components to prevent transmission of blood-borne diseases caused by bacteria, viruses and protozoa.

## Needle exchange programs

Needle exchange programs (NEPs) are an attempt to reduce the spread of blood-borne diseases between intravenous drug users. They often also provide addiction counseling services, infectious disease testing, and in some cases mental health care and other case management. NEPs acquired their name as they were initially places where intravenous (IV) illicit substance users were provided with clean, unused needles in exchange for their used needles. This allows for proper disposal of the needles.[23] Empirical studies confirm the benefits of NEPs.[24] NEPs can affect behaviors that result in the transmission of human immunodeficiency virus. These behaviors include decreased sharing of used syringes, which reduces contaminated syringes from circulation and replaces them with sterile ones, among other risk reductions.[25][26]

## Prevention

PPE suit Sign for airborne precautions procedures that can be posted outside patient rooms

Follow standard precautions to help prevent the spread of blood-borne pathogens and other diseases whenever there is a risk of exposure to blood or other bodily fluids. Standard precautions include maintaining personal hygiene and using personal protective equipment (PPE), engineering controls, and work practice controls among others.[27] Always avoid contact with blood and other bodily fluids. Wear disposable gloves when providing care, particularly if you may come into contact with blood or bodily fluids. Dispose of gloves properly and change gloves when providing care to a new patient. Use needles with safety devices to help prevent needlestick injury and exposure to blood-borne pathogens.[28] It is also recommended healthcare workers who come often in contact with contaminated material should get vaccinated against hepatitis B.[10] A hierarchy of controls can help to prevent environmental and occupational exposures and subsequent diseases. These include:[29][30]

* Elimination: Physically remove hazards, including needles that lack a safety device. Additionally, eliminate the use of needle devices whenever safe and effective alternatives are available.
* Substitution: Replace needles without safety devices with ones that have a safety feature built in. This has been shown to reduce blood-borne diseases transmitted via needlestick injuries.
* Engineering controls: Isolate people from the hazard by providing sharps containers for workers to immediately place needles in after use, which means putting them within arm's reach of wherever patient treatment occurs, such as in every physician's exam room, every draw station in a medical lab, and every bedside in a hospital ward or wing.
* Administrative controls: Change the way people work by creating a culture of safety such as avoiding recapping or bending needles that may be contaminated and promptly disposing of used needle devices and other sharps.

Personal protective equipment: Protect workers with PPE such as gloves and masks to avoid transmission of blood and other bodily fluids.[citation needed]

There have been reports of HCW transferring disease to patients. This happens usually when surgeons perform EPPs, which are procedures requiring sharp tools.[citation needed]

## Post-exposure protocol

* Immediate actions: Wash needlesticks and cuts with soap and water; flush splashes to nose, mouth, or skin with water; irrigate eyes with clean water, saline, or sterile wash.[31]
* TestReporting: Promptly report exposures to receive appropriate follow-up care.[citation needed]

## See also

* BTSB anti-D scandal
* Contaminated haemophilia blood products
* Contaminated blood scandal in the United Kingdom
* Hematology
* HIV-tainted blood scandal (Japan)
* Infected blood scandal (France)
* Plasma Economy
* Royal Commission of Inquiry on the Blood System in Canada

## References

1. ↑ Laureen Veevers (1 October 2006). "'Shared banknote' health warning to cocaine users". The Observer. http://cocaine.org/cokemoney/banknotes.html.
2. ↑ "Bloodborne Infectious Diseases: HIV/AIDS, Hepatitis B, Hepatitis C". https://www.cdc.gov/niosh/topics/bbp/default.html.
3. ↑ Jason J. Pirozzolo; Donald C. LeMay (July 2007). "Blood-Borne Infections". Clinics in Sports Medicine (Clinics.com) 26 (3): Volume 26, Issue 3, 425–431. doi:10.1016/j.csm.2007.04.010. PMID 17826193. http://www.sportsmed.theclinics.com/article/S0278-5919(07)00020-8/abstract. Retrieved February 23, 2014.
4. ↑ "Global HIV & AIDS statistics — Fact sheet" (in en). https://www.unaids.org/en/resources/fact-sheet.
5. ↑ "Hepatitis B Facts and Figures". https://www.hepb.org/what-is-hepatitis-b/what-is-hepb/facts-and-figures/.
6. ↑ "Hepatitis C" (in en). https://www.who.int/news-room/fact-sheets/detail/hepatitis-c?utm_source=chatgpt.com.
7. ↑ "Transfusion-Transmitted Diseases: Overview, Bacterial Infections, Viral Infections". Medscape. 2024-10-29. https://emedicine.medscape.com/article/1389957-overview?utm_source=chatgpt.com&form=fpf.
8. ↑ "Exposure to blood; what healthcare personnel need to know" (in en). Exposure to What Healthcare Personnel Need to Know Department of Health & Human Services 1. https://stacks.cdc.gov/view/cdc/6853?utm.
9. ↑ "Bloodborne Infectious Disease Risk Factors" (in en-us). 2024-12-19. https://www.cdc.gov/niosh/healthcare/risk-factors/bloodborne-infectious-diseases.html.
10. ↑ 10.0 10.1 10.2 Deuffic-Burban, S.; Delarocque-Astagneau, E.; Abiteboul, D.; Bouvet, E.; Yazdanpanah, Y. (2011-09-01). "Blood-borne viruses in health care workers: Prevention and management". Journal of Clinical Virology 52 (1): 4–10. doi:10.1016/j.jcv.2011.05.016. ISSN 1386-6532. PMID 21680238. https://www.sciencedirect.com/science/article/pii/S1386653211001880.
11. ↑ 11.0 11.1 S. Deuffic-Burbana, E. Delarocque-Astagneauc, D. Abitebould, E. Bouvetd, Y. Yazdanpanah Blood-borne viruses in healthcare workers: Prevention and management. Journal of Clinical Virology 52(2011) 4–10
12. ↑ Alfulayw, Kifah Habib; Al-Otaibi, Sultan T.; Alqahtani, Hatem A. (2021-10-09). "Factors associated with needlestick injuries among healthcare workers: implications for prevention". BMC Health Services Research 21 (1): 1074. doi:10.1186/s12913-021-07110-y. ISSN 1472-6963. PMID 34627244.
13. ↑ "Exposure Control Plan for Occupational Exposure to Bloodborne Pathogens | Worcester Polytechnic Institute". https://www.wpi.edu/offices/environmental-health-safety/laboratory/exposure.
14. ↑ 14.0 14.1 Annette Prüss-Üstün, Elisabetta Rapiti, and Yvan Hutin Estimation of the Global Burden of Disease Attributable to Contaminated Sharps Injuries Among Health-Care Workers. American Journal of Industrial Medicine 48:482–490 (2005)
15. ↑ Patrick, Deval (March 2012). Governor. Boston, MA: Massachusetts Department of Public Health. pp. 1–24. http://www.mass.gov/eohhs/docs/dph/occupational-health/injuries/injuries-hospital-2010.pdf.
16. ↑ Centers for Disease Control and Prevention. "Stop Sticks Campaign". https://www.cdc.gov/niosh/stopsticks/safersharpsdevices.html. This article incorporates text from this source, which is in the public domain.
17. ↑ Benoit, Patrick; Brazer, Noah; de Lorenzi-Tognon, Mikael; Kelly, Emily; Servellita, Venice; Oseguera, Miriam; Nguyen, Jenny; Tang, Jack et al. (December 2024). "Seven-year performance of a clinical metagenomic next-generation sequencing test for diagnosis of central nervous system infections" (in en). Nature Medicine 30 (12): 3522–3533. doi:10.1038/s41591-024-03275-1. ISSN 1546-170X.
18. ↑ Larkins, Michael C.; Thombare, Aparna (2025), "Point-of-Care Testing", StatPearls (Treasure Island (FL): StatPearls Publishing), PMID 37276307, https://www.ncbi.nlm.nih.gov/books/NBK592387/#:~:text=Point-of-Care Testing (,care or treatment is provided., retrieved 2025-04-13
19. ↑ Kaminski, Michael M.; Abudayyeh, Omar O.; Gootenberg, Jonathan S.; Zhang, Feng; Collins, James J. (July 2021). "CRISPR-based diagnostics" (in en). Nature Biomedical Engineering 5 (7): 643–656. doi:10.1038/s41551-021-00760-7. ISSN 2157-846X. https://www.nature.com/articles/s41551-021-00760-7.
20. ↑ Allain, Jean Pierre; Bianco, Celso; Blajchman, Morris A.; Brecher, Mark E.; Busch, Michael; Leiby, David; Lin, Lily; Stramer, Susan (April 2005). "Protecting the blood supply from emerging pathogens: the role of pathogen inactivation". Transfusion Medicine Reviews 19 (2): 110–126. doi:10.1016/j.tmrv.2004.11.005. ISSN 0887-7963. PMID 15852240.
21. ↑ Yin, Yundi; Li, Ling; Gong, Li; Xu, Haixia; Liu, Zhong (November 2020). "Effects of riboflavin and ultraviolet light treatment on pathogen reduction and platelets". Transfusion 60 (11): 2647–2654. doi:10.1111/trf.16053. ISSN 1537-2995. PMID 32866308.
22. ↑ "Mechanism of Action - Amotosalen". 2016-02-17. https://interceptbloodsystem.com/en/blood-center/intercept/mechanism-action-amotosalen.
23. ↑ "Needle Exchange: A Primer". http://www.pbs.org/wgbh/pages/frontline/aids/past/needle.html.
24. ↑ Lurie, Peter (1993). The Public Health Impact of Needle Exchange Programs in the United States and Abroad. San Francisco, CA: UC Berkeley School of Public Health. https://caps.ucsf.edu/uploads/pubs/reports/pdf/NEPReportSummary1993.pdf.
25. ↑ CDC (2024-06-20). "Syringe Services Programs" (in en-us). https://www.cdc.gov/syringe-services-programs/php/index.html.
26. ↑ "Preambles to Final Rules | OSHA.gov | Occupational Safety and Health Administration" (in en). https://www.osha.gov/laws-regs/preambles.
27. ↑ Fact Sheet. "Preventing the Spread of Bloodborne Pathogens". The American National Red Cross. http://www.in.gov/isdh/files/BBP_American_Red_Cross_Fact_Sheet_xps(1).pdf.
28. ↑ "CDC - Stop Sticks : Safer Sharps Devices - NORA" (in en-us). 2019-05-08. https://www.cdc.gov/nora/councils/hcsa/stopsticks/safersharpsdevices.html.
29. ↑ "Identifying Hazard Control Options: The Hierarchy of Controls". https://www.osha.gov/sites/default/files/Hierarchy_of_Controls_02.01.23_form_508_2.pdf.
30. ↑ "Bloodborne Pathogens Training & Certificate Online". https://www.hipaaexams.com/compliance-training-courses/OSHA-Bloodborne-Pathogens-training.
31. ↑ CDC (2020-07-07). "Protect yourself. Protect your family. Protect the public. Bloodborne pathogen exposure." (in en-us). Bloodborne Pathogen Exposure. doi:10.26616/NIOSHPUB2007157. https://www.cdc.gov/niosh/docs/2007-157/default.html.

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