I would like to share a personal experience I recently encountered with fellow veterinary nurses. As a part of a routine day’s work I was called to assist in taking a blood sample from a cat. The owner was present in the consult room and offered to help restrain the cat as it became fractious and difficult to obtain the sample from. As the vet was extracting the sample from the jugular vein the cat struggled and bit the owner on the hand. He bled profusely from the wound and the blood dripped onto the back of my hand where I had a small cut. The blood was sufficient to run across the back of my hand and drip from the tips of my fingers. It was at this point the cat’s owner advised me of some serious details regarding his health.
He said, ‘I should probably let you know, I am Hepatitis C positive and on the methadone programme. You should get yourself checked out’.
After some frantic scrubbing with iodine I phoned the local medical centre for advice and was informed the nurse would see me straight away. I didn’t know a great deal about Hepatitis C or the potential diseases I could have been exposed to, but knew enough to know this incident could be serious.
Hepatitis: what is it?
Hepatitis refers to an inflammatory process that occurs in the liver. This inflammation can be caused by contagious diseases such as viral infections (Hepatitis B virus (HBV), Hepatitis C virus (HCV)). Hepatitis can also be caused by exposure to alcohol, certain medications, chemicals, poisons, and other toxins, or by other diseases. Hepatitis C is caused by HCV, a human and chimpanzee only virus classified as a separate genus (hepacivirus), belonging within the flaviviradae family which includes yellow fever and dengue fever. It affects the liver cells; chronic infection leads to scarring of the liver and ultimately to cirrhosis. In time those with liver cirrhosis can go on to develop liver failure or liver cancer.
At the medical centre the nurse took details regarding time and type of exposure and how the incident occurred. A blood sample was taken to obtain information on my levels of HCV and HBV antibodies and also human immunodeficiency virus (HIV) antibodies. This would provide a base from which any changes would be apparent following further blood tests in the future. These tests were repeated at 3, 6 and 12 months post exposure. If the antibody levels were to increase, particularly at the 6 month test, then this could indicate a presence of the virus.
Review of practice
Following this incident our clinic staff reviewed our procedures when taking blood samples:
- We now take the animal through to another room while the owner waits in the consult room or they may leave the animal with us and collect later
- We cover any cuts with a waterproof dressing
- We wear protective clothing, e.g. gloves, when handling samples. It is important not to forget about the zoonotic diseases
- We ensure tetanus vaccinations are current and consider vaccinating against HBV
- We ensure we are very careful when handling sharps.
My results
I am pleased to report all of my blood samples were normal. My HBV antibody levels were ideal due to a vaccine 2 years previously. There were no change in the HCV and HIV antibodies. This was a huge relief as there were many months of uncertainty regarding my health.
This was a huge lesson for all staff at our clinic and I sincerely hope this does not happen to any fellow veterinary staff elsewhere.
One thing I may suggest is that we as veterinary nurses cannot be too complacent in our jobs. Our industry has multiple hazards that we are exposed to every day. Always be on the lookout for potential hazards in your workplace and remember it is your responsibility to take care of your own health.