Doctors Fear Catching With Worst Infections

Healthcare Workers Face Anything from Anthrax to HIV

In an emergency room, patients often arrive in acute situations bringing a heightened risk that healthcare providers may be exposed to dangerous infectious diseases. In this setting, a full medical history isn’t available.

“A lot fear HIV the most, though it is least likely to be transmitted in that situation,” says Pritish K. Tosh, MD, infectious disease specialist at the Mayo Clinic in Rochester, Minnesota. And rarely, infectious agents are mistakenly released from research labs, like the live anthrax bacteria from a U.S. Department of Defense project which got into the FedEx mail system, detected May 27, as reported by CNN.

Two of the predominant ways health workers may contract diseases on the job are accidental sticks with an infected needle and inhalation of an infectious virus or bacteria. Following are six serious infections doctors may face at work, along with the effective courses of treatment available.

Anthrax: A Potential Bioterror Threat

Anthrax is a potential bioweapon, according to Dr. Tosh, notable not because of the number of deaths it causes but because “there is so much fear surrounding it.” Anthrax is caused by bacteria that normally live in the soil, but the bugs are also the subject of defense research.

People may contract anthrax from inhaling spores, touching the bacteria if they have an open cut, being exposed to dead animals that were infected, or eating infected meat.

Today, in the United States, this kind of infection is extremely rare, and anthrax scares are more often linked with bioterror events, like the 2001 attacks which caused 22 infections and five deaths, notes the National Institutes of Health National Library of Medicine. Inhalation of anthrax spores is the greatest fear, which can leave a person sick with pneumonia very quickly.

There is a vaccine, but it is typically only given to people who were exposed or are at the highest risk of anthrax infections. Antitoxins and antibiotics like ciprofloxacin, doxycycline, or amoxicillin treat anthrax infections, according to the Centers for Disease Control and Prevention (CDC), but these must be taken quickly after exposure to be effective.

HIV: A Treatable, Sexually Transmitted Disease

HIV, the human immunodeficiency virus, is transmitted through bodily fluids. There are a couple of factors that impact how infectious the condition is, says Jonathan L. Jacobs, MD, infectious disease specialist at New York-Presbyterian/Weill Cornell Medical Center. One is called viral load, or the amount of virus present in the person with HIV. Shortly after infection and later in the illness, an individual has more of the virus in their blood, and is more infectious.

The second variable is the type of exposure. Contact with someone’s saliva brings an almost negligible rate of infection, while a needle stick has a higher infection rate, and receptive anal sex brings the highest rate of sexual exposure. According to the CDC, the highest rate of infection overall is through blood transfusion.

Antiretroviral medications given to people at high-risk of contracting HIV reduce the risk of infection after exposure by up to 96 percent, if taken within the first three days. This is called post exposure prophylaxis, or PEP. Combinations of medications, like tenofovir-emtricitabine and raltegravir among others, are effective in reducing the viral load. But they have side effects including nausea, vomiting, headaches, fatigue, and rashes.

Hepatitis C: A Curable Blood-Borne Virus

Hepatitis C is a liver disease caused by a virus that produces symptoms that range from mild liver inflammation to cancer, cirrhosis, and liver failure. The risk of liver cancer and cirrhosis is increased in people with chronic hepatitis C. The virus is transmitted through contact with infected blood, by sharing needles, or from an accidental needle stick.

It can also be passed through sexual contact, most commonly between homosexual men, Jacobs said. The disease can be prevented by not sharing needles with someone who is infected and using safe sex practices with partners who may have the condition. The good news, however, is that in the population that requires treatment, antiviral medication cures the condition for over 90 percent of patients.

Hepatitis B: A Vaccine-Preventable Infection

A serious liver infection, hepatitis B is also caused by a virus. In a mild form, it causes inflammation of the liver. But if not treated, it can cause liver cancer or cirrhosis to develop over time.

The virus is spread through blood and bodily fluids. It can be transmitted through needle sticks, needle sharing, through sexual intercourse, or from an infected mother to a child during birth. The hepatitis B vaccination is 95 percent effective at preventing infection by the virus, and most health workers are vaccinated.

Nearly all adults infected with hepatitis B recover on their own within a year’s time, without a need for treatment, notes the World Health Organization. Fewer than 5 percent of people with the virus end up with a chronic condition. There is no cure for chronic hepatitis B, but antiviral medication can help suppress the condition.

Whooping Cough: A Highly Infectious Condition

Whooping cough, or pertussis, is a highly infectious respiratory condition caused by bacteria. It is spread when someone infected coughs or sneezes near someone who inhales the bacteria. For adults, whooping cough can lead to prolonged periods of uncontrollable coughing. In infants, whooping cough can be serious enough that children can stop breathing.

There are vaccinations – DTaP for children and Tdap for adults – to prevent whooping cough infections. The vaccinations are typically given to babies beginning at two months of age. Adults should get vaccinated again as an adult, typically after the age of 19, Jacobs said.

Mothers should also get the vaccine during the third trimester of each pregnancy, so the child can receive protective antibodies in utero. If someone is exposed to whooping cough, he or she can be treated immediately with the antibiotic azithromycin, which reduces the chance of infection.

Meningitis: An Infection Affecting the Brain

Unlike whooping cough, meningitis is not as highly contagious, but the results of an infection can quickly become catastrophic. Meningitis is caused by a virus or by bacteria that create inflammation in the membranes around the brain and spinal cord, notes the CDC.

Transmission of meningitis occurs through exposure to respiratory droplets from an infected person. This can occur when a provider hooks a patient to a ventilator in an emergency room. It is also sometimes seen in areas where people are in close quarters like dorm rooms or soldiers’ barracks.

If left untreated, Tosh said the condition is “almost universally fatal,” so patients need to seek treatment immediately. Antibiotics can be given immediately after exposure to reduce the chance of infection for bacterial meningitis. Fortunately, there is a routine childhood vaccine that can prevent infection. The vaccination is also recommended again for students before going to college.