Blood Borne Virus Infections (including HIV)
Hepatitis B, Hepatitis C and HIV are the 3 main blood borne viruses (BBVs). They are transmitted through exposure of broken skin, mucous membranes and blood to infected blood and body fluids, for example during treatment with reused medical/dental/surgical equipment, body piercings and tattoos performed with non-sterile equipment or sharing of drug injecting equipment. They are also transmitted sexually.
Initial infection with a BBV may cause no symptoms but can produce severe illness. Although Hepatitis B and C may spontaneously clear, BBVs can cause life long infection. Hepatitis C infection can be cured with oral treatment. Chronic Hepatitis B infection and HIV infection cause life-long infection that can be controlled with treatment.
Travel can increase the risk of exposure to BBVs:
- Travelling for cosmetic/dental/medical/surgical procedures in less developed countries increases the chance of exposure to blood borne viruses.
- Travelling in remote and rural parts of the developing world increases the risk of exposure to poor medical facilities.
- Adventure tourism (rafting, climbing, trekking) in the developing world increases the risk of accident and injury and exposure to poor medical facilities.
- Road traffic accidents are the major cause of travel associated illness/injury and increase the risk of exposure to poor medical facilities.
- Unprotected sex during travel with a new/casual partner or sex worker increases the risk of BBVs.
- Travelling to work/volunteer in medical settings in the developing world increases the chance of occupational exposure to BBVs.
Hepatitis B is vaccine preventable and vaccine should be considered if you may be at risk of exposure – this should be discussed with a travel health advisor.
There is no vaccine against Hepatitis C or HIV.
BBVs are transmitted by the same routes. Even if vaccinated against Hepatitis B, the following points should be noted to reduce the risk of Hepatitis C and HIV.
- Practice safe sex during travel.
- Comprehensive travel insurance that includes medical repatriation is important. Ensuring you can access a high standard of medical care/return to the UK reduces the chance of exposure to unsafe medical/surgical/dental equipment and blood products.
- Blood transfusion: In most of Western Europe, North America, Japan and Australasia all donated blood is now screened for blood borne viruses. Blood transfusion services in many developing countries are basic and much of the blood donated may be unscreened. The risks from blood transfusion in such circumstances are high. Points to consider are:
- Accidents are the commonest reason for needing a blood transfusion.
- Consider joining the Blood Care Foundation (see below).
- Consider carrying a more comprehensive medical/first aid travel kit if travelling to a resource poor setting: The reuse of medical supplies, including needles and syringes is common in many resource poor countries.
- Travel packs are available from large pharmacies, travel shops/clinic and online retailers. Depending on the kit, they may contain sterile injecting equipment, wound suture needles and intravenous drip set. For customs clearance these kits must be supplied with a certificate showing contents and the reason for its purchase.
- Procedures such as ear piercing, tattooing, acupuncture, manicure and shaving with open razors should be avoided unless you know the equipment involved has been adequately sterilised/is single use.
- Do not reuse/share any recreational drug taking equipment.
- The penalties for use of recreational drugs are severe in many countries.
- If hiring vehicles abroad make sure they are road worthy and that you are familiar with the road rules. Use the same amount of caution and protection (helmets, seat belts, protective clothing) as you would in the UK. For further information see Accident Prevention.
- If travelling for cosmetic/dental/medical/surgical procedures, research carefully beforehand and ensure they use sterile single use equipment and have a high standard of infection control. For further information see Medical Tourism.
- If travelling to work/volunteer in a medical setting ensure you are fully familiar with the risks of blood borne viruses in an occupational setting.
- Check your Hepatitis B vaccine titres are adequate and obtain booster doses of vaccine if necessary.
- For information on HIV Post-Exposure Prophylaxis (PEP) please refer to the HIV Post-Exposure Prophylaxis (PEP) Information for Travellers advice sheet.
This is an example of an organisation which aims to make reliably screened blood, blood products and sterile equipment available to its members in case of emergency.
Blood is supplied to the nearest scheduled airstrip at points in Africa, Kenya, Tanzania, Uganda, Angola, Congo, Zaire, Zimbabwe, China, South Korea and Maldives. Clearly however this does not usually help with immediate need for these products, for example, after massive blood loss in an accident.
For further information contact:
- Membership and General enquiries: Mr. Julian Bruce
- Telephone: 01403 262 652
- Fax: 01403 262 657
- Website: www.bloodcare.org.uk