NEEDLESTICK INJURY

ARCHES IS COMMITTED TO KEEPING YOU AND YOUR FAMILY SAFE.

What do I do if I am poked by a needle? 

If you or your loved one is poked by a needle, the risk for a contracting a virus is low, but you should still seek out medical attention as soon as possible.  

If you are poked by a needle: 

  • Let the wound bleed as much as possible 
  • Flush the wound as much as possible 
  • Wash the would well with soap and warm water 
  • Seek medical help as soon as possible  

Be ready to tell your healthcare provider: 

  • If there was blood on the needle tip 
  • If there was any liquid inside the syringe and the colour of the liquid 
  • Where the incident happened 
  • If the needle looked clean or dirty 
  • The location of the poke on your body
  • If any substance was also injected when you were poked  

There are a lot unknowns when it comes to the risk of getting sick from a needle poke in the community. Studies of needle poke incidents often look at what the risk is for occupational exposures in a healthcare setting. The risk of contracting a virus such as HIV, Hepatitis C, or Hepatitis B is much lower for a cold needle found in the community.  

What Viruses are you at risk for if you are poked by a needle?

Hepatitis C, Hepatitis B, and HIV. Although the risk of contracting any of these viruses from a cold, abandoned needle in the community is very low.  

What is HIV?

HIV or Human Immunodeficiency Virus attacks the immune system. It works by infecting your immune cells and reduces your body’s ability to fight infections. HIV can be passed by blood, semen, vaginal fluid and breast milk. It can enter the body through open wounds and mucous membranes. A person will rarely if ever contract HIV through their digestive tract. HIV is treatable but not curable. With antiretroviral medication you can live a long healthy life. Individuals who have HIV and take their medication regularly can reach HIV levels in their blood so low that they are undetectable. For these individuals, it is virtually impossible to pass HIV to another person.  

What is Hepatitis C?

Hepatitis C is a virus that infects liver cells. Once inside your liver cells your body’s immune system fights your own liver cells. This causes scarring, which can lead to cirrhosis. Hepatitis C is usually spread when blood from a person infected with the hepatitis C virus enters the body of someone who is not infected. There is no vaccine for Hepatitis C. However, there is medication available that can cure it.  

What is Hepatitis B?

Hepatitis B is also a virus that infects liver cells. Once inside your liver cells, your body’s immune system fights your own liver cells. This causes scarring, which can lead to cirrhosis. The hepatitis B virus is spread when blood, semen, or other body fluid infected with the hepatitis B virus enters the body of a person who is not infected. There is no cure for Hepatitis B. There is a vaccine for Hepatitis B, and medication that can help treat Hepatitis B if you are infected. If you have recently been exposed to Hepatitis B and you are not vaccinated, there is post-exposure prophylaxis that is effective at preventing Hepatitis B infection. 

THERE HAVE BEEN NO DOCUMENTED CASES OF HIV SEROCONVERSION SECONDARY TO A COLD, ABANDONED NEEDLESTICK INJURY IN THE COMMUNITY

What is my risk of contracting a virus from a cold, abandoned needle in the community?

The risk of getting sick from a needle stick injury if the needle is found in the community is low. There have been no cases of seroconversion to HIV reported from an abandoned needlestick injury in the community. There have been few cases of Hepatitis B and Hepatitis C. In all cases other sources of infection could not be ruled out.   

There are several studies that have looked at infection rates from abandoned needlestick injuries: 

No cases of HIV secondary to community-acquired needlestick injuries in pediatric patients

This study included children presenting with community-acquired needlestick injuries to Montreal Hospitals. Of the 274 pediatric patients included in this study, there were no seroconversions upon testing for hepatitis B, C and HIV. This confirms that the risk of transmission of bloodborne viruses for a community-acquired needle stick for pediatric populations is very low.  

Jesse PapenburgDenis BlaisDorothy MooreMohammed Al-HosniCéline LaferrièreBruce TapieroCaroline Quach American Academy of Pediatrics 

Review finds no documented case of HIV occurring secondary to community-acquired needlesticks with cold needles in individuals of any age group

This is a systemic review of the literature looking at the transmission of blood borne infection after a community-acquired needle stick injury. Between 1987 and 2011, 1565 cases of community-acquired needlesticks were reported in 16 observational studies. HIV post exposure prophylaxis (PEP) was recommended in 198 cases. Where reported, adherence to prescribed HIV PEP was generally poor. Of the 1565 cases, 1 unvaccinated adult caring for a relative with chronic Hep B infection, in a country with a relatively high Hep B infection rate without routine Hep B vaccination, developed evidence of Hep B infection in the 8 weeks after sustaining a needlestick injury while disposing of a needle and after declining post exposure Hep B immunoglobulin and vaccination. There were no other cases of HIV, Hep B, or Hep C reported when serology was done. Five case reports were also found: 2 for Hep B and 3 for Hep C. In all cases, possibility of alternative routes of transmission could not be ruled out.

Joshua Osowicki, Nigel Curtis Archives of Disease in Childhood

Abandoned needlestick injuries of 484 consecutive patients presenting to a Vancouver ED resulted in no seroconversion despite low use of PEP 

The study looked at ER visits in at a Vancouver hospital for blood and bodily fluid exposures. There were 329 occupational needle stick injuries from an abandoned needle and 155 non-occupational needle stick injuries from abandoned needles. None of the patients who had follow up testing seroconverted despite very few of them receiving PEP. Guidelines for PEP indicate that PEP is not required for cold needle stick injuries.  

Shannon O’donnell, Tahara D. Bhate, Eric Grafstein, William Lau, Robert Stenstrom, Frank X. Scheuermeyer Archives of Disease in Childhood

Other Information:

Position statement from Canadian Pediatric Society reports no documented cases of HIV after community needlestick injury 

This position states that the risk of infection is low, however assessment, follow up and counselling for the child and parents is still recommended. Post-exposure prophylaxis is indicated on a case by case basis.  

Post Exposure Prophylaxis Protocol in Alberta 

The Alberta protocol for PEP recommends that cold needle exposures (e.g., needle stick injuries from a needle found in the community) rarely requires post-exposure prophylaxis for HIV. Post exposure prophylaxis for Hep B may still be indicated.