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Year : 2013  |  Volume : 31  |  Issue : 1  |  Page : 98--99

Occupational exposure to Human Immunodeficiency Virus infection: A case missed is a life lost

SA Ganju, S Bhagra, RC Guleria, V Sharma, AK Kanga 
 Department of Microbiology, IGMC, Shimla, India

Correspondence Address:
S A Ganju
Department of Microbiology, IGMC, Shimla
India

How to cite this article:
Ganju S A, Bhagra S, Guleria R C, Sharma V, Kanga A K. Occupational exposure to Human Immunodeficiency Virus infection: A case missed is a life lost.Indian J Med Microbiol 2013;31:98-99

How to cite this URL:
Ganju S A, Bhagra S, Guleria R C, Sharma V, Kanga A K. Occupational exposure to Human Immunodeficiency Virus infection: A case missed is a life lost. Indian J Med Microbiol [serial online] 2013 [cited 2019 Nov 22 ];31:98-99
Available from: http://www.ijmm.org/text.asp?2013/31/1/98/108760

Full Text

Dear Editor,

World Health Organisation estimates that the global burden of disease from occupational exposure among Health Care Worker [HCW] s to be 40% of hepatitis B and C infections and 2.5% of HIV infection. [1] Worldwide there are more than 60 million non-institutional births each year with a vast majority being attended by Traditional Birth Attendants [TBA]s. [2] TBAs have deficient knowledge regarding modes of Human Immunodeficiency Virus (HIV) transmission and may not be able to protect themselves and others from HIV. [3] This report (i) probably documents the first case of occupationally acquired HIV infection in a TBA and (ii) highlights the importance of consistent use of universal work precautions [UWP].

A 66 year-old woman, working as a TBA for the past 35 years, was admitted to a tertiary care hospital with complaints of high-grade fever, headache and altered behaviour for the last 2 days. Her medical history showed that she had taken complete anti-tubercular treatment under directly observed treatment short course for sputum-positive pulmonary tuberculosis one year back. She had undergone a computed tomography scan head for complaints of frequent headaches in which no abnormal finding was detected. There was no history of blood transfusion or major surgery in the past. No history of high-risk behaviour could be elicited. The clinical and laboratory profiles are shown in [Table 1]. She was diagnosed as a case of HIV/AIDS with cryptococcal meningitis. Treatment with amphotericin B one mg/kg/day IV was started with the plan to start antiretroviral therapy, but the patient died after 2 days.{Table 1}

In India and our state, assistance during deliveries at home has been reported in 30.9% and 27.8% of live births, respectively, by untrained functionaries. [4] Neglect of UWPs can put patients and the TBAs at risk of contracting HIV. [1] In this case, it appears that the TBA had several exposures to blood and amniotic fluid and could have acquired infection, through non-intact skin. [5] Thus, adequate training and unfailing practice of UWP could have prevented exposure to HIV.

References

1Wilburn SQ, Eijkemans G. Preventing needlestick injuries among healthcare workers: A WHO-ICN collaboration. Int J Occup Environ Health 2004;10:451-6.
2World Health Organization. Traditional birth attendants: A joint WHO/UNICEF/UNFPA statement. Geneva: World Health Organization; 1992.
3Madhivanan P, Kumar BN, Adamson P, Krupp K. Traditional birth attendants lack basic information on HIV and safe delivery practices in rural Mysore, India. BMC Public Health 2010;10:570.
4Health and Family Welfare Department. Himachal Pradesh. Health at a Glance. Himachal Pradesh 2010;1-8.
5Beltrami EM, Kozak A, Williams IT, Saekhou AM, Kalish ML, Nainan OV, et al. Transmission of HIV and hepatitis C virus from a nursing home patient to a health care worker. Am J Infect Control 2003;31:168-75.