Path: utzoo!attcan!uunet!cs.utexas.edu!sdd.hp.com!usc!ucla-cs!Richard.DeWald@f70.n382.z1.fidonet.org From: Richard.DeWald@f70.n382.z1.fidonet.org (Richard DeWald) Newsgroups: sci.med.aids Subject: A few questions Message-ID: <36679@shemp.CS.UCLA.EDU> Date: 2 Jul 90 14:07:25 GMT Sender: news@CS.UCLA.EDU Organization: FidoNet node 1:382/70 - Humanitas, Austin TX Lines: 121 Approved: phil@wubios.wustl.edu Note: Copyright 1990 by Daniel R. Greening. Permission granted for Note: non-commercial reproduction. Archive-number: 2240 In an article of <29 Jun 90 06:27:11 GMT>, dr@cs.columbia.edu writes: dA>Q1) If AIDS is so fragile that it requires intimate physical contact, dA>and one cannot catch it via food, toliet seats, kissing, etc, how come dA>IV drug users need to worry about infected needles that have been dA>"repackaged". It seems to me that if a needle is sitting out for dA>several days that the virus should be dead????? Summary -- how does dA>AIDS survive in a needle outside of the body? Addicts that share needles generally do so immediately. Technically, HIV (Human Immunodeficieny Virus) does not "live" at all. We speak of virii as "remaining viable" instead of living. A virus is just a protein-coated set of chemical instructions for the "machinery" inside of a living cell to dutifully carry out. These instructions generally focus on replication of the virus. Specifically, HIV is a set of instructions for a specialized cell of the immune system called a "T-cell" to carry out. This interrupts the normal work of that cell, that causes the syndrome of illnesses we call AIDS. The HIV virus seems to need the very narrowly-defined environment that is present in the blood stream (or something as equally narrowly-defined that you provide in a laboratory) in order to remain viable. HIV is very small, a very little drop of blood is a relative great lake for the virus dA>Q2) I've seen reference to safer sex and safe sex. Which term is more dA>appropriate? Obviously, no activity (sexual or otherwise) is dA>completely dA>safe (one can sneeze while driving and drive off a cliff.....), but is dA>sex w/ a condom considered safe (assuming the condom is used dA>correctly)? It is considered to be worth the risk, not absolutely safe, if you properly use a condom. Forms of sexual intimacy that are less-likely to traumatize a condom are considered "safer." dA> dA>Q3) Has HIV been isolated in saliva? There seems to be some dA>controversy about this issue. The controversy surrounds the viability of the HIV in saliva. dA>technician with whom I dealt). One) The technician used an alcohol dA>swab to clean the skin. Alcohol, although it probably will kill HIV on dA>contact, does not necessarily kill hepatitis. Neither of these virus strains would be present in a viable form on your skin!!! The alcohol is used to kill BACTERIA and it does so rather effectively, effectively enough for a needle stick. Only certain kinds of bacteria are on your skin, those that can potenitially infect a clean needle stick are instantly destroyed by alcohol. dA>the swab back and forth, instead of in the spiral motion (from the dA>center which is standard sterile technique. Your technician was using what is known as "clean" technique, not sterile technique. His or her technique is near perfect from the way you describe it. dA>wore the same pair of gloves for me as he did for the previous (and dA>probably)subsequent victims. It protects him, but not us! The alcohol swab is to protect you. dA>vacutainer container has been known to fill up with blood. However, dA>these plastic tubes were re-used from patient to patient. As long as the needles aren't used from patient to patient, this is acceptable (if aesthetically displeasing) technique. None of the blood in the vacutainer will ever get into a sample tube, or be introduced into the patient's bloodstream, so what's the big deal. However, a dirty vacutainer would be discarded just because no one likes to work with dirty equipment. dA>1) train technicians (and doctors/nurses) to put on new gloves with dA>every patient. Generally we do. Phlebotemists generally leave their gloves on between patients if they are sitting in one spot. Again, the gloves are to protect them, you are correct. dA>2) Use iodine compounds to clean skin before taking blood (I was told dA>that people can develop a sensitivity to iodine-compounds, maybe this dA>is a problem) The needless greater expense is also a problem. Provodine (what you are really referring to) scrubs are used if a needle is going to stay in place for any length of time. dA>3) Clean vacutainer tubes between uses in dilute chlorine bleach. If we are referring to the same piece of equipment, what you are describing is essentially a needle holder. It should be clean, but since it is never introduced into a body and it shoudl never come into contact with bodily fluids, it is not necessary to do anything other than keep it clean. dA>I imagine that many people who draw blood not highly trained nor dA>supervised. Of course I estimate that the potential danger to me, dA>personally, is very low, even if an HIV infected person was immediately dA>before me in line, when applied to an entire population it could be dA>significant. It doesn't take a rocket scientist to stick a vein. The ONLY danger you could be in (rather than intense anxiety) from following an AIDS victim at the lab is if the technician used the same needle. This is a mortal sin, this would lose the facility it's license instantly and forever. If you ever see this happen, you have an easy multi-million dollar lawsuit in your lap. It is more likely that in your state of paranoia you didn't think this through carefully enough. Your needle was sterile, your skin was clean. You were safe. dA>Does anybody out there know of any studies documenting the dA>effectiveness of vacutainers in preventing the spread of blood-borne dA>diseases patient to patient? Vacutainers are designed to make taking blood samples from people easier. They do not have as their mission the prevention of the spread of diseases. Richard DeWald, BSN Student Univ. of TX - Austin. -- Uucp: ...{gatech,ames,rutgers}!ncar!asuvax!stjhmc!382!70!Richard.DeWald Internet: Richard.DeWald@f70.n382.z1.fidonet.org