Bloodborne Infection Risks in Acupuncture Practices

Q: Bloodborne Infection Risks in Acupuncture Practices

Hello, regarding your questions： <br>First, if your wound has come into contact with another person's blood, there is indeed a risk of bloodborne infection. <br><br>Second, if the other person is confirmed to be negative for Hepatitis B/C and HIV, then you would not be at risk of

Hepatitis B/C, HIV, syphilis, bloodborne infections from acupuncture?

Hello, doctor.
I have a question regarding an incident at an acupuncture clinic.
After the acupuncture needles were removed, there was some bleeding.
The physician mistakenly used a cotton ball that had been used to stop bleeding for a previous patient to apply pressure to my bleeding site.
Since the previous patient also had bleeding, the cotton ball was potentially contaminated.
My first question is, does this situation pose a risk for transmission of Hepatitis B/C, HIV, or syphilis through blood? I had blood tests done immediately, and all results for Hepatitis B/C, HIV, and syphilis were "non-reactive." However, my report indicated that my Hepatitis B antibody level was low, with "Anti HBs 0.95." The physician mentioned that if I was concerned, I could follow up later.
My concern is whether the situation I described meets the definition of a bloodborne disease transmission risk.
If sharing a razor can transmit infections, then what about my situation?
My second question is, is there a risk of infection from the blood on the cotton ball coming into contact with my acupuncture site? The previous patient is elderly, born before 1985, and has not received the Hepatitis B vaccine.
Since the incident, I have been experiencing unexplained abdominal tightness and bloating.
Is this likely due to psychological stress or could it indicate something else?
Lastly, if the previous patient tests negative for Hepatitis B/C and HIV, does that mean I have no risk of infection? Can patients request testing through the health department or relevant agencies to eliminate concerns for both parties, rather than having to wait three to six months for follow-up testing, which can be quite distressing?

YANNY, 20~29 year old female. Ask Date: 2018/05/21

Dr. Hong Yuanbin reply Internal Medicine

Hello, regarding your questions:
First, if your wound has come into contact with another person's blood, there is indeed a risk of bloodborne infection.

Second, if the other person is confirmed to be negative for Hepatitis B/C and HIV, then you would not be at risk of infection; however, this is contingent upon having clear test results confirming their negative status.

Third, if you are unable to obtain the other person's blood test information, it is advisable to follow up for Hepatitis B/C and HIV testing at 3, 6, and 12 months to determine if you have been infected.

Fourth, currently, there is no clear legal basis to compel the other person to undergo blood testing in your case.
It is recommended that you try to request the other patient to undergo relevant tests through the clinic or health department.

Thank you for your inquiry.

Reply Date: 2018/05/21

More Info

Understanding the risks of bloodborne infections in acupuncture practices is crucial, especially in scenarios where there may be exposure to blood from other patients. Your situation raises several important questions regarding the transmission of bloodborne pathogens such as Hepatitis B (HBV), Hepatitis C (HCV), HIV, and syphilis.

Risk of Transmission
1. Exposure to Contaminated Materials: In your case, the use of a cotton ball that had been in contact with another patient's blood does pose a risk for transmission of bloodborne pathogens. However, the actual risk depends on several factors, including the presence of infectious agents in the blood, the volume of blood, and the nature of the exposure (e.g., whether the blood directly entered your bloodstream through an open wound).

2. Testing Results: Your blood tests showing "non-reactive" results for HBV, HCV, HIV, and syphilis are reassuring. However, the presence of a low level of Hepatitis B antibodies (Anti HBs 0.95) indicates that you may not have sufficient immunity against Hepatitis B. It is advisable to follow up with your healthcare provider regarding the need for a booster vaccination for Hepatitis B, especially since you have had a potential exposure.

3. Infection Risk from Blood Contact: If the cotton ball had visible blood and pressed against your acupuncture site, there is a theoretical risk of infection. However, the likelihood of transmission of HBV, HCV, or HIV through such contact is generally low, especially if there was no direct entry of blood into your bloodstream. The Centers for Disease Control and Prevention (CDC) states that the risk of transmission through intact skin is negligible.

Follow-Up and Monitoring
1. Monitoring Symptoms: The abdominal discomfort you are experiencing could be related to anxiety or stress following the incident, but it is also important to monitor for any signs of infection or other health issues. If symptoms persist or worsen, seeking medical attention is advisable.

2. Testing of the Other Patient: If the other patient has tested negative for HBV, HCV, and HIV, it significantly reduces your risk of infection. However, without confirmation of their status, it is prudent to continue monitoring your health and possibly retesting at the recommended intervals (3, 6, and 12 months) to ensure that no infection has occurred.

3. Access to Testing for Both Patients: In terms of obtaining testing for the other patient, it may be challenging to compel them to undergo testing due to privacy laws and regulations. However, you can discuss your concerns with the acupuncture clinic and see if they can facilitate communication with the other patient or provide guidance on how to proceed.

Conclusion
In summary, while there is a theoretical risk of bloodborne infections in the scenario you described, your current test results are reassuring. It is essential to maintain open communication with your healthcare provider, follow up on your Hepatitis B immunity, and monitor your health for any changes. If you have ongoing concerns, discussing them with a specialist in infectious diseases may provide additional peace of mind. Remember, the best prevention against bloodborne infections in clinical settings is strict adherence to infection control protocols, including the use of sterile equipment and proper disposal of contaminated materials.

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