Hepatitis C is a blood-borne virus.
Transmission of hepatitis C may only occur when the blood of an infected person enters the bloodstream of another person.
The point of entry for infected blood can be a fresh cut or broken or punctured skin. The hepatitis C virus cannot penetrate unbroken skin and is killed by the digestive juices in the stomach if it is swallowed.
Injecting drug use
Injecting equipment includes needles, syringes, spoons, swabs, tourniquets, water and filters. Sharing injecting equipment is the most common way of becoming infected in Australia.
Around 80% of infections in Australia have resulted from the sharing and re-using of injecting equipment and currently around 90% of new infections occur this way.
In situations where people are injecting, small amounts of blood may be present on a person’s finger, on a tourniquet, or on a bench top or tabletop, and transmission may occur even if people do not share or re-use needles.
To reduce the risk of hepatitis C transmission, it is important that people who inject drugs:
- Do not share or re-use needles, tourniquets, spoons, swabs, water or any other equipment, even when no blood is visible.
- Special care should be taken when injecting occurs in groups, or when people are being assisted to inject by others.
- Label or mark your syringe.
- People should thoroughly wash their hands in warm soapy water before and immediately after injecting (if this is impossible, use single wipes with new swabs instead).
- When using in groups or injecting others, that people do not recap someone else’s needles.
- Everyone should be encouraged to manage sharps in a safe manner by disposing of all equipment in an approved disposal container (available from your needle and syringe program).
Body art and piercing
MEDIUM – HIGH RISK
Body art and piercing procedures are not always carried out under sterile conditions and although single-use needles are now common, dye and dye tubs (ink pots) may be re-used for multiple customers.
If you get a non-professional tattoo or piercing in a juvenile detention centre, prison, or by a backyard operator your chance of becoming infected with the hepatitis C virus is very high.
The equipment they use is often not clean and has nearly always been used on other people before your turn.
Anyone considering a piercing, or a tattoo should make sure that their tattoo artist or body-piercer:
- Uses infection control precautions, which means using single-use disposable needles, dye tubs, surgical gloves, and so on.
- Customers have the right to ask the practitioner about their infection control procedures (especially if overseas & you would like to find out what hygiene practices are used).
- In Australia, practitioners are legally required to apply infection control procedures.
- Some tattoo shops may ask clients to disclose their hepatitis C status.
This practice is unlawful and no one is obliged to disclose their status if they do not wish to do so. It is the responsibility of the practitioner to take infection control precautions for every customer.
Mother to baby
Around 5% of babies may acquire the virus from a mother who has hepatitis C. The hepatitis C virus does not appear to pass through the placenta during pregnancy.
The risk of transmission occurs during the birthing process when the mother’s blood is present and there is the possibility of a skin injury to the baby, allowing blood-to-blood contact and therefore transmission to potentially occur.
Needle stick injury in a health care setting
These occur mainly in occupational settings such as hospitals and clinics, where handling bloody items may also present a risk.
Overall the risk of acquiring hepatitis C from needle-stick (or sharps) injury in a health care setting is around 3%.
This risk depends on a number of factors, such as the size of the needle and the depth of penetration achieved.
Health care and custodial workers are advised to take infection control precautions at all times and should consider being vaccinated against hepatitis A and B.
Needle stick injury in a non-health care setting
EXTREMELY LOW RISK
Experiencing a needle stick injury while picking up rubbish or stepping on a used needle in a public place, such as a street, a park or a beach, is regarded as very unlikely as a source of transmission of hepatitis C.
Worldwide as of January 2008 there have been three (3) documented cases* of hepatitis C transmission via community needle stick injury.
*Needle-stick injury in a non-health care setting.
Ref: Journal of Gastroenterology and Hepatology (2007) Volume: 22, Issue: 11, Pages: 1882-1885. Clin Infect Dis. (2005) 41 (1): 129-130.
EXTREMELY LOW RISK
Recent international studies have shown that hepatitis C is not a sexually transmissible infection (STI).
Levels of the virus found in bodily fluids usually exchanged during sex such as semen, saliva and vaginal secretions, are not high enough to be considered as posing a risk.
For hepatitis C transmission to occur, blood from an infected person has to get into the blood stream of another person.
As with any activity, caution should be exercised if blood is likely to be present during sex.
For example, sex during menstruation, anal sex, abrasive sex that may cause bleeding, or if someone has a condition that involves sores or blisters in the genital region and there is a possibility that these may come into contact with a partner’s blood during sex.
Medical and dental procedures
Performed in Australia: EXTREMELY LOW RISK
Performed Overseas: VARIABLE RISK
Infection control guidelines, designed to prevent the transmission of blood borne viruses and other diseases, are strictly adhered to in medical settings in Australia.
In some other countries a lack of resources, inadequate infrastructure, a lack of training, or a combination of these factors can create circumstances in which reducing the risk of transmitting diseases is not always possible.
Undergoing medical or dental treatment in some countries may carry with it the possibility of acquiring hepatitis C.
Sharing personal grooming aids
EXTREMELY LOW RISK
Items used for everyday hygiene may present a possible transmission risk if blood is present.
To minimise the risk of transmission within the home, it is suggested that people do not share razor blades, toothbrushes (due to the possibility of bleeding gums) and sharp personal grooming aids.
When wiping up blood spills, it is advisable to wear gloves and use paper towels and lukewarm soapy water (bleach can also be used to disinfect the area).
Mother to baby
Delivery techniques may be slightly modified in order to minimise any damage to the baby’s skin (not using forceps or scalp electrodes) and so minimise the risk of transmission of hepatitis C from mother to baby during the birth.
For this reason, mothers who have hepatitis C may wish to inform those involved in the birth (such as midwives, doctors, etc) of their status, and those who believe they may have been exposed to hepatitis C in the past may wish to be tested prior to delivery.
Blood spills at home or at the workplace
When wiping up blood spills, it is advisable to wear gloves, use paper towels and scrub the spill with lukewarm soapy water. Cuts and abrasions should be covered.
All workplaces are legally required to apply infection control procedures, in which any blood spills are treated as potentially infectious and are dealt with in a safe manner.
These procedures should be outlined in workplace health and safety policies. If you’re concerned about transmission in the workplace you can contact your health and safety officer, union, or call our LiverLine (1800 703 003).
In all medical settings, standard precautions must be applied to all potentially infectious material.
These are precautions that have been developed to make sure that both patients and health care workers are protected from infection as much as possible.
Therefore, all bodily fluids are treated as infectious and there is NO need for anyone to disclose his or her viral status since no special precautions are required.
All medical equipment is either sterilised before use with each patient or is only for single use, while gloves and other protective gear will be used to prevent staff to patient infection.
In addition, many exposed surfaces will have protective coverings on them, which are replaced for each patient.
People concerned about transmission in a health care setting should ask the medical staff about their infection control procedures.
Remember, the best way to prevent transmission of hepatitis C is to be tested and cured.