Beware of Needlesticks as Zika Looms

April 25th, 2016

By Gary Evans, Senior Staff Writer

Increased transmission of Zika virus is expected in the U.S. as mosquitoes continue to emerge in the warmer months, raising a critical question for healthcare workers: Can Zika be transmitted from an infected patient by a needlestick? The default answer for now is: Yes.

Though it was not known at this writing whether any such case of occupational Zika infection has been documented, there is every reason to err on the side of caution given that Zika has already been transmitted sexually and is causing an unprecedented level of birth defects. In addition, one would intuitively think the stick of a needle containing Zika virus-contaminated blood would simulate transmission via the mosquito's penetrating proboscis -- though the latter is said to probe with an impressive flexibility. Even if Zika is injected into a worker via a needle, other variables like the viral titer circulating in the patient's blood and the immune status of the injured worker would in part determine the likelihood of subsequent infection. .

In any case, prevention of the needlestick is the best way to prevent occupational spread of Zika and other bloodborne pathogens. Thus public health officials are emphasizing in new Zika prevention guidelines for workers that the Occupational Safety and Health Administration requires the following:

• Follow workplace standard operating procedures (e.g., workplace exposure control plans) and use the engineering controls and work practices available in the workplace to prevent exposure to blood or other potentially infectious materials.
• Do NOT bend, recap, or remove contaminated needles or other contaminated sharps. Properly dispose of these items in closable, puncture-resistant, leakproof, and labeled or color-coded containers.
• Use sharps with engineered sharps injury protection to avoid sharps-related injuries.
• Report all needlesticks, lacerations, and other exposure incidents to supervisors as soon as possible.

Employers should consider enhanced precautions in situations where workers are at increased risk of exposure to Zika virus or other hazards, according to recommendations issued by OSHA and the Centers for Disease Control and Prevention. Healthcare workers should use standard precautions during patient care regardless of suspected or confirmed Zika infection status.

“While there is no evidence of Zika transmission through aerosol exposure, minimizing the aerosolization of blood or body fluids as much as possible during patient care or laboratory tasks may help prevent workers from being exposed to other pathogens,” the guidelines state. “Additional protections, including engineering controls to ensure containment of pathogens or enhanced PPE to prevent or reduce exposure, may be necessary during any aerosol generating procedures or other such tasks.”

For more on this story see the June 2016 issue of Hospital Employee Health. And for additional coverage on Zika, please view the March and April issues of Hospital Infection Control & Prevention.

For more AHC Media coverage on this vital issue, please visit reliasmedia.com/Zika.