Blood Borne Virus Infections (including HIV)

• Introduction
• Recommendations for Travellers
• Vaccination
• The Illness
• Further Information

Introduction

Hepatitis B, Hepatitis C and HIV are the 3 main blood borne viruses (BBVs). They are transmitted through:

• Exposure (of broken skin, mucous membranes or blood) to infected blood and body fluids, for example during:
  • treatment using reused or non sterile medical, dental or surgical equipment
  • blood or blood product transfusion
  • body piercings and tattoos performed with non-sterile equipment
  • sharing of drug injecting equipment
• Sex: oral, vaginal or anal

The risk of being exposed to a BBV infection is increased by:

• having unprotected sex with a new or casual partner or sex worker in any country.

You can also be exposed to BBVs through medical treatment, particularly in countries with limited medical facilities or less strict infection control and hygiene practices. Types of travel that can increase your risk of requiring medical treatment might include:

• Travelling for cosmetic, dental, medical or surgical procedures 
• Adventure tourism (rafting, climbing, trekking)
• Travelling to work or volunteer in medical settings
• Remote and rural travel in areas where medical facilities are basic or absent
• Travel to low and middle income countries
  • Road traffic accidents are the major cause of travel associated illness and injury.
  • 90% of road traffic deaths occur in low and middle income countries.

Recommendations for Travellers

All BBVs are transmitted in the same way. Even if you are vaccinated against Hepatitis B, you should still take preventative steps to reduce your risk of exposure to Hepatitis C and HIV:

• Practice safe sex during travel.
• Purchase comprehensive travel insurance that includes medical repatriation.
  • Ensuring that you can access a high standard of medical care, or return to the UK for treatment reduces your chance of exposure to BBVs.
• Consider carrying a comprehensive medical/first aid travel kit if you are travelling to a resource poor setting to avoid exposure to reused or unsterile medical supplies.
  • Travel kits are available from large pharmacies, travel shops, clinics and online retailers. Depending on the kit, they may contain sterile injecting equipment, wound suture needles and intravenous drip set.
  • For customs clearance these kits must be supplied with a certificate showing the contents and the reason for its purchase.
• Avoid procedures such as ear piercing, tattooing, acupuncture, manicures and shaving with open razors unless you know the equipment being used has been adequately sterilised or is single use.
• Avoid using, reusing or sharing any recreational drug taking equipment.
  • The penalties for use of recreational drugs are severe in many countries.
• If hiring vehicles abroad make sure they are road worthy and that you are familiar with the local road rules.
  • Use the same amount of caution and protection (helmets, seat belts, protective clothing) as you would in the UK.
• If travelling for cosmetic, dental, medical or surgical procedures, research the clinic or hospital beforehand and ensure they use sterile, single use equipment and have a high standard of infection control.
  • For further information see the Medical Tourism page.
• If travelling to work or volunteer in a medical setting ensure you are fully familiar with the risks of blood borne viruses in an occupational setting.
  • Check your Hepatitis B vaccine titres and obtain booster doses of vaccine if necessary.
  • For information on HIV Post-Exposure Prophylaxis (PEP) please refer to the HIV Post-Exposure Prophylaxis (PEP) Information for Travellers advice sheet.

Blood transfusion
In Western Europe, North America, Japan and Australasia all donated blood is now screened for blood borne viruses. Blood transfusion services in many resource poor countries are basic, and much of the donated blood may be unscreened. The risks from receiving a blood transfusion in such circumstances are high.

• Accidents are the commonest reason for needing a blood transfusion.
• Consider joining the Blood Care Foundation (see below).

Vaccination

Hepatitis B vaccine should be considered if you may be at risk of exposure. This should be discussed with your travel health advisor.

There is no vaccine against Hepatitis C or HIV.

The Illness

Initial infection with a BBV may cause no symptoms or can produce an initial severe illness. Although initial infection with Hepatitis B and C may spontaneously clear, all 3 BBVs can cause life-long infection.

Hepatitis C infection can be cured with oral treatment.

Chronic Hepatitis B infection and HIV infection cannot be cured but the life-long infection can be controlled with treatment.

Further Information

The Blood Care Foundation is an organisation which aims to make reliably screened blood, blood products and sterile equipment available to its members in case of emergency.

The Foundation uses a network of internationally recognised sources, from where screened blood can be dispatched to members anywhere in the world in an emergency. However this does not usually help with an immediate need for blood transfusion, for example, after massive blood loss in an accident.

• Blood Care Foundation Website

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