question

July 27, 2004

There are issues with serving food when you have hep c. I don't know the

laws/rules, but what if one got a small nick and a drop of blood fell in

someones food. But like I said...I don't know the rules/laws.

question

I was wondering if anyone could tell me if they test for HepC when

you get a health card? I have someone who is trying to cause me

trouble for working with foods. I am extremely careful and never do

anything with knives if I can help it.

I need some info to show this person if they decide to get ugly about

it. It is a volunteer thing and not every day...just occasionally.

And from ya'll...should I be handling food?

<><TammieD><>

July 28, 2004

--- tammster62 <t1d1r1d1@...> wrote:

> I was wondering if anyone could tell me if they test for HepC when

> you get a health card? I have someone who is trying to cause me

> trouble for working with foods. I am extremely careful and never do

anything with knives if I can help it.

> I need some info to show this person if they decide to get ugly

> about it. It is a volunteer thing and not every day...just

occasionally. And from ya'll...should I be handling food?

> <><TammieD><>

Everytime I read something like this it makes me so mad! How do you

find something to prove it's safe to handle and work with foods when

there are no studies since HCV is a BLOOD BORNE ILLNESS! It is not

passed in food, there has never been any suspision it could be passed

in food, therefore finding any study which says " HCV cannot be passed

in food " is probably hopeless. My cousin is a chef AND in charge of

the restaurants owned by a large resort hotel chain. He has HCV, has

known he had for much longer than me, and it has NEVER been an issue.

No, HCV is not checked for when you get a health card because HCV

cannot be passed while preparing or serving food. It requires blood

to blood contact. I don't know if this will help but here is an

article on more unusual routes of HCV transmission which have been

identified:

NATAP - www.natap.org

42nd ICAAC

Interscience Conference on Antimicrobial Agents & Chemotherapy

Sept 27-30, 2002

San Diego, CA

all ICAAC reports archived at NATAP website

Hepatitis ICAAC Report 1: Identifying unknown routes for HCV

transmission

Reported by Jules Levin

There were several sessions devoted to HCV/HIV coinfection at this

year's ICAAC. This is a good sign saying that at least ICAAC and I

think the HIV scientific community is beginning to recognize the

importance of addressing HCV in HIV, and is beginning to incorporate

research and education about HCV into the various HIV scientific

conferences and meetings. There were two symposiums and Meet-The

-Experts panel lectures at this ICAAC meeting. As well, there was a

significant poster session and oral slide session devoted to HCV. The

quality of the abstracts and sessions were mixed, and doctors at the

symposium and docs I met at the conference displayed to me an

inadequate and sometimes misinformed knowledge about treating HCV in

HIV. Progress in HCV/HIV is very slow and the Federal government is

slow in recognizing and funding areas of need in HCV and HCV/HIV

coinfection, including prevention, an adequate care infrastructure,

and education for the HIV Community (doctors, patients, service

providers). Following this report will be a series of additional

ICAAC Hepatitis Reports. All ICAAC and other conference reports are

posted to and archived at the NATAP website

(www.natap.org).

G Raguin and a French research group (abstract V-681) reported on

what was widely considered an interesting study: " A National

Multicenter Case-Control Study of Risk Factors for Community-Acquired

Hepatitis C " . Certain risk factors for acquiring HCV have been

identified. Transfusions used to be a major risk until the blood

supply was cleaned by developing testing for blood supply and now

this risk is considered very low. Currently, IVDU and sharing related

drug using paraphenalia such as needles are considered the major risk

for acquiring HCV. However, 20-40% of HCV-infected do not have

recognized risk factor, leading to speculations that other

as-yet-undiscovered modes of transmission may exist. This French

study is a case-control study to investigate the routes of

transmission in patients with no recognized risk factor.

Several potential routes or sources of HCV transmission have been

suggested: previous hospitalization or surgery, hemodialysis and

plasmapheresis, organ transplantation, GI endoscopy, parenteral

treatment (IV) for schistosomiasis, tatooing, piercing, nasal cocaine

use, activities during incarceration. This study sets out to test

these ideas.

HCV-seropositive pts were recruited in 57 French hospitals. Controls

(comparison group) were recruited from the general population through

a random telephone survey and matched for age, sex, residence and

number of chronic diseases. All answered an epidemiological

interviewer-administered questionnaire on potential risk factors for

HCV. HCV+ patients were excluded if they had a history of transfusion

or IV drug use. Patients with sexual and occupational exposure, HIV

infection, hemodialysis and transplantation were also excluded.

Controls were matched with the case patients for age, sex, residence.

500 HCV-infected patients (age 53.4; males 55%) and 750 controls were

studied between 1997 and 2000. 72% of HCV-infected patients had

chronic hepatitis, 9% had cirrhosis, and 9% had asymptomatic HCV with

normal liver enzymes. 65% had genotype, 25% genotype 2 or 3. 50% of

cases and control patients had 1 or more chronic diseases.

RESULTS

The authors reported that this large case-control study identified 15

independent risk factors for HCV infection in patients with no

standard risk factors. The authors said they confirm these suspected

risk factors such as: hospital stays, GI endoscopy, abortion, IV=IM

injections, acupuncture, and intrnasal cocaine. They reported

identifying these new risk factors: violent sports, manicure/chiropy,

and depilation. The authors reported that altogether these risk

factors could explain 74% of unidentified routes of infection. For

hospitalization, GI endoscopy and IV/IM injections have positive

correlation with the number of exposures and risk for acquiring HCV.

The Odds Ratio for GI endoscopy in this study was 2.1 if person had

less than 2 exposures and 4-fold risk if person had greater than 2

exposures. A sensitivity analysis, performed on 2 subsets of subjects

gave similar results. The authors conclude that this study shows that

hospital stays, GI endoscopy, some dermatological procedures and

cocaine use are risk factors for community-acquired HCV in France,

and we also provide evidence for less-recognized risk factors.

Here are the odds ratios for increased risk by these exposures. All

are statisticaly significant.

Hospitalizations

Surgery (non obstetrical) 1.7 fold increased risk

Medical (any reason) 2.1

Endoscopy

Digestive 1.9 (risk not increased by biopsy & anasthesia)

Obstetrical

Voluntary abortion 1.8

Dermatological Procedure

Varicose vein sclerosing 1.7

Diathermy 3.0

Cutaneous ulcers, wounds 10.0

Ambulatory Care

Acupuncture 1.6

Tetanus Ig injection 1.7

IM injection 1.4

IV injection 1.7

Lifestyle

Chiropodist/manicurist 1.8

Depilation at beauty salon 2.0

Violent sport (boxing, rugby) 2.4

Intranasal cocaine 4.6

For some of these risk factors the number of study subjects among

cases and controls were small and the confidence ratio wide but these

risk factors were all statistically significant.

The following were NOT associated with acquiring HCV infection.

Obstetrical surgery, delivery

Non digestive endoscopy, puncture, biopsy, catheterisation

Miscarriage, in vitro fertilization, IUD

Electromyography

Hemorroid care

Ambulance use

Other ambulatory procedures: mesotherapy, infiltrations,

desensitization

Dental procedures

Other lifestyle: tatooing, piercing, contact lenses, shaving

Incarceration, military service

July 28, 2004