Bloodborne pathogens (BBPs) are microorganisms such as viruses or bacteria that are carried in human blood and can cause disease in people. There are many different bloodborne pathogens including malaria, syphilis, and brucellosis, but Hepatitis B (HBV), Hepatitis C (HCV), and the Human Immunodeficiency Virus (HIV) are the three diseases specifically addressed by the bloodborne pathogens standard.
This training is limited to human pathogens carried in human blood, not animal blood. Contact your supervisor for information on other diseases you may encounter and the appropriate protective measures.
Hepatitis B (HBV)
"Hepatitis" means "inflammation of the liver," and, as its name implies, Hepatitis B is a virus that infects the liver. While there are several different types of Hepatitis, Hepatitis B is transmitted primarily through blood contact. HBV initially causes inflammation of the liver, but it can lead to more serious conditions such as cirrhosis and liver cancer.
There are over 1 million people infected with HBV in the U.S. and there are approximately 32,000 new infections annually. There are approximately 3,000 HBV related deaths a year.
There is no "cure" or specific treatment for HBV, but many people who contract the disease will develop antibodies, which help them recover and protect from future infections. Immunity to HBV will not prevent you from getting other types of hepatitis.
The Hepatitis B virus is very durable, and it can survive in dried blood for over seven days. For this reason, HBV is a major concern for employees such as custodians, laundry personnel and other employees who may come in contact with blood or potentially infectious materials.
The symptoms of HBV are like a mild "flu". Initially there is a sense of fatigue, possible stomach pain, loss of appetite, and even nausea. As the disease continues to develop, jaundice (a distinct yellowing of the skin and eyes), and a darkened urine will often occur. However, people who are infected with HBV will often show no symptoms for some time. After exposure it can take 1-9 months before symptoms become noticeable. Loss of appetite and stomach pain, for example, commonly appear within 1-3 months, but can occur as soon as 2 weeks or as long as 6-9 months after infection.
Hepatitis C (HCV)
Hepatitis C is a disease of the liver caused by the hepatitis C virus (HCV). Approximately 16,000 new HCV infections are estimated to occur each year. It is estimated that 4 million (1.6%) Americans have been infected with HCV, of whom over 3 million are chronically infected. Some might not be aware of their infection because 80% do not have signs or symptoms. Infected persons serve as a source of transmission to others and are at risk for chronic liver disease or other HCV related chronic diseases. HCV is the most common chronic bloodborne infection. HCV testing is recommended for routine screening of asymptomatic persons based on their risk for infection or recognized exposure. Treatments are available which have shown effectiveness at eliminating the disease in some people.
Persons with acute infection typically are either asymptomatic or have a mild illness. If symptoms do occur, one out of five may have jaundice, dark urine, clay-colored stools, or flu-like symptoms such as fatigue, abdominal pain, loss of appetite or nausea. After acute infection, up to 1/4 of persons appear to resolve their infection without treatment. Regardless of how the HCV infection is resolved, it does not provide immunity to reinfection. Chronic HCV infection develops in the remaining 75%-85% of persons infected, with chronic liver disease developing in 70% of cases. Extreme fatigue is a very common symptom in persons with chronic hepatitis C.
A person can be infectious without having symptoms for 3 to 16 weeks. It plays a role in many cases of chronic hepatitis, cirrhosis and liver cancer. A small percentage of people who appear to be healthy carry the hepatitis C virus and have undetectable chronic hepatitis or even cirrhosis. The course of chronic liver disease caused by HCV usually progresses at a slow rate without producing any symptoms or physical signs in the majority of people during the first two or more decades of infection.
Human Immunodeficiency Virus (HIV)
AIDS, or acquired immune deficiency syndrome, is caused by a virus called the human immunodeficiency virus, or HIV. Once a person has been infected with HIV, it may be many years before AIDS actually develops. HIV attacks the body's immune system, weakening it so that it cannot fight other deadly diseases. AIDS is a fatal disease, and while treatment for it is improving, there is no known cure.
Over 1 million people are living with HIV/AIDS in the United States today, with about 50,000 people infected every year. Approximately 16,000 people die annually in the United States.
The HIV virus is very fragile and will not survive very long outside of the human body. It is primarily of concern to custodians, healthcare professionals, first-aid responders, and researchers working with human blood or other potentially infectious materials (OPIM). HIV is a devastating disease; therefore, all precautions must be taken to avoid exposure.
People may not have any symptoms when first infected with HIV. They may, however, have a flu-like illness within a month or two after exposure to the virus. This illness may include:
- Enlarged lymph nodes (glands of the immune system easily felt in the neck and groin)
As the immune system weakens, a variety of complications will emerge. For many people, the first signs of infection are large lymph nodes or "swollen glands" that may be enlarged for more than 3 months. Other symptoms often experienced months to years before the onset of AIDS includes:
- Lack of energy
- Weight loss
- Frequent fevers and sweats
- Persistent or frequent yeast infections (oral or vaginal)
- Persistent skin rashes or flaky skin
- Pelvic inflammatory disease in women that do not respond to treatment
- Short-term memory loss
- Some people develop frequent and severe herpes infections that cause mouth, genital, or anal sores, or a painful nerve disease called shingles.