Human Bites: Bloodborne Pathogen Risk and Postexposure Follow-up Algorithm

Lohiya, Ghan-Shyam; Tan-Figueroa, Lilia; Lohiya, Sapna; Lohiya, Sunita

doi:10.1016/s0027-9684(15)30090-0

Cited by 8 publications

(17 citation statements)

References 5 publications

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“…19,21 Eikenella corrodens was isolated in 17% to 30% of cases in several studies. 22,23 Risk is significantly increased when blood is present, however (0.1% to 0.3%). Pure gram-negative or anaerobic infections are uncommon.…”

Section: Human Bitesmentioning

confidence: 98%

“…22,23 Risk is significantly increased when blood is present, however (0.1% to 0.3%). 22,23 An HBV surface antigen titer should be obtained regardless of vaccination status. 22 This is a combination of antiretroviral medications used to treat AIDS; a 28-day prophylactic course is recommended after exposure.…”

Section: Human Bitesmentioning

confidence: 98%

“…22 If HIV infection is known or suspected and there was visible blood present at the time of injury, the CDC recommends postexposure prophylaxis with highly active antiretroviral therapy. 22,23 If the HBV status of the biter is unknown, and HBV antibodies are insufficient or absent, then the accelerated course of the HBV vaccine may be administered. 22 The patient should also have a baseline blood test to determine preexposure HIV status, with retesting performed at 3 and 6 months.…”

Section: Human Bitesmentioning

confidence: 99%

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Human and Other Mammalian Bite Injuries of the Hand

Kennedy

Stoll

Lauder

2015

Journal of the American Academy of Orthopaedic Surgeons

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The hand is the most common site for bite injuries. Because of specific characteristics of hand anatomy, bite mechanics, and organisms found in human and animal saliva, even small wounds can lead to aggressive infections. Failure to recognize and treat hand bites can result in significant morbidity. Human and animal bites most commonly lead to polymicrobial bacterial infections with a mixture of aerobic and anaerobic organisms. Pasteurella species are commonly found in dog and cat bite wounds, and Eikenella is characteristic of human wounds. Staphylococcus, Streptococcus, and anaerobic bacterial species are common to all mammals. Although public health measures in developed countries have been highly effective at reducing rabies transmission, dog bites remain the most common source of rabies infection worldwide. Human bites can transmit HIV, hepatitis B, or hepatitis C, especially when contaminated blood is exposed to an open wound. Appropriate management of any mammal bite requires recognition, early wound cleansing, evaluation of injured structures, and infection prophylaxis. Structural repair is performed as indicated by the severity and contamination of the injury, and wounds may require delayed closure. Wound infections typically require débridement, empiric antibiotics, and delayed repair or reconstruction.

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Section: Human Bitesmentioning

confidence: 98%

Section: Human Bitesmentioning

confidence: 98%

Section: Human Bitesmentioning

confidence: 99%

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Human and Other Mammalian Bite Injuries of the Hand

Kennedy

Stoll

Lauder

2015

Journal of the American Academy of Orthopaedic Surgeons

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“…Several reports describe instances in which HIV transmission has been associated with human bites. 37,38 Evaluation of the bitten individual should include baseline testing for preexisting HIV infection, an offer of PEP if the patient is exposed to HIV, and follow-up identical to that described for other parenteral HIV exposures. Perpetrators of sexual assault are considered to be a high-risk population for HIV infection and PEP should be offered for these cases.…”

Section: Assessment Of the Need For Occupational And Non Occupationalmentioning

confidence: 99%

Prevention of Human Immunodeficiency Virus and AIDS

Beekmann

Henderson

2014

Infectious Disease Clinics of North America

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“…EBV is highly infectious via the oral route, which is reflected in the common name given to HIV and hepatitis B and C viruses are typically transmitted by blood or sexual contact but have also been detected in saliva. Hepatitis B transmission can occur through saliva [5], but there are no established reports of transmission via saliva for HIV or hepatitis C [6]. Ebola virus is present in the saliva of infected individuals and although it seems likely that transmission via saliva does occur, the significance of this route of transmission is unclear, particularly as the virus is inactivated rapidly in saliva [7].…”

mentioning

confidence: 99%