Exposure to Blood and Body Fluids • Back to Main Menu The Leeds, Grenville and Lanark District Health Unit developed Guidelines for Managing Exposures to Blood Borne Pathogens to support health care providers in their assessment and management of persons with accidental exposures to blood and body fluids that may be infected with hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). The guidelines address both occupational and non-occupational exposures. All persons with significant recent exposures to blood or body fluids should be immediately referred to the nearest emergency department. The Health Unit is currently revising this document and an updated version will be available by December 2008. Full Document: (bookmarked/indexed) Guidelines for Managing Exposures to Blood Borne Pathogens (222 kb PDF ) Table of Contents Introduction  - Page 3 Occupational Exposure to Blood/Body Fluids - Page 4 A. Initial Management Guidelines I. General Measures  - Page 4 II. Evaluate the Significance of the Exposure  - Page 4 III. Serologic Testing for HBC, HCV and HIV  - Page 6 • Test the Source Patient • Test the Exposed Patient IV. Options Under the Health Protection & Promotion Act: Bill 105  - Page 7 B. Post Exposure Follow-up: Human Immunodeficiency Virus (HIV) I. Risk of HIV Infection Post Exposure  - Page 7 II. Efficacy of Antiretroviral Chemoprophylaxis  - Page 8 III. The Importance of Timing  - Page 8 IV. Medication Availability and Cost (Antiretrovials)  - Page 8 V. Serologic Testing (if antiretrovirals are indicated)  - Page 8 C. Post Exposure Follow-up: Hepatitis B Virus (HBV) I. Risk of HBV Infection Post Exposure  - Page 10 II. Post Exposure Prophylaxis for HBV  - Page 10 D. Post Exposure Follow-up: Hepatitis C Virus (HCV) I. Risk of HCV Infection Post Exposure - Page 12 II. Post Exposure Prophylaxis for HCV/Early Treatment for HCV - Page 12 E. Post Exposure Counseling I. Risk of Infection Post Exposure  - Page 12 II. Reporting Illness in the Follow-up Period  - Page 13 III. Secondary Spread  - Page 13 IV. Medication (PEP) Compliance and Medical Follow-up  - Page 13 Managing Non-Occupational Exposures to Blood/Body Fluids  - Page 15 F. Community Acquired Needle Stick Injuries I. Decisions Surrounding Community Exposures  - Page 15 II. Infectious Risks Page 15 III. Counseling Recommendations and Follow-up  - Page 16 G. Sexual Exposures I. Evidence of Current Practice  - Page 16 II. The Risk of Transmission from a Single HIV Exposure  - Page 16 III. Health Unit Commentary  - Page 16 H. Human Bites I. Significance of the Exposure  - Page 17 II. Management of Human Bites  - Page 17 I. Important Contact Information  - Page 18 Appendix A Appendix B Appendix C References