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HIV and AIDS. Andrew De S aro , EMT-B, BS, DC , DICCP, P h C (hon ). safety & Awareness. OPIM’s PPE All Fluids are infectious until proven otherwise Be mindful of your surrounding. Routes of transmission. Contact – most common Direct - indirect
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HIV and AIDS Andrew De Saro, EMT-B, BS, DC, DICCP, PhC(hon)
safety & Awareness • OPIM’s • PPE • All Fluids are infectious until proven otherwise • Be mindful of your surrounding
Routes of transmission • Contact – most common • Direct - indirect • Droplet – coughing, talking, sneezing • Air – small particulates (TB or Varicella) • Food – Salmonella, E. coli, Listeria • Vector – fleas, mosquitoes, birds, & rodents
Airborne pathogens • Influenza • 1-3 days incubation • Swine & Avian • Tuberculosis • 6 weeks to show positive • Meningitis • 2-10 days • Pertussis • avg 9-10 days (6-20) • SARS • approx 3-10 days
Airborne pathogens • Measles • avg 14 days (7-21) • Mumps • 14-25 day range • Rubella • avg 14 days (12-23) • Varicella • 2-3 weeks
Blood Borne Pathogens • Hepatitis – A, B, & C • HIV
What is HIV? Retrovirus Incapable of Reproduction HIV to AIDS Controversy HIV vs AIDS
HIV History 1st HIV case 1959 1st US HIV case 1981(CDC) 1st Time CDC uses AIDS 1982 1st FDA Approved Home Test 2002 2016: 36.7 mill have HIV worldwide 1 mill AIDS-related Illness Deaths 2017: 20.9 mill getting antiretroviral therapy (AZT or HAART)
Transmission • Sexual Intercourse with infected partner • Pregnancy, Childbirth, & Breastfeeding • Sharing Needles with infected persons
How HIV is NOT Transmitted Through the Air – coughing or sneezing Through Food or Water Through Sweat or Tears Sharing Cups, Plates, or Utensils Touching, Hugging, or Kissing Living with an Infected Person Sharing Clothes or Shaking Hands Sharing Toilets and Bathrooms Vectors – mosquitoes, fleas or other insects
Signs and Symptoms • Fatigue • Night Sweats • Sudden Weight Loss • Reoccurring Infections • Cancer
Endocrinologic Manifestations Skin Manifestations Gynecologic Manifestations HIV-Related Malignancies Kaposi’s sarcoma non-Hodgkin’s lymphoma Primary Brain lymphoma Invasive cervical carcinoma Clinical Findings
Differential Diagnosis • Essentials of Diagnosis • Risk Factors • Systemic Complaints • Opportunistic Infections • Aggressive cancers • Neurologic manifestations
Confirmation of HIV Infection • Positive HIV Test • Repeatedly positive ELISA – 2 or more • Western Blot the final confirmation • Positive 10-14 days after HIV infection • most within 3-4 weeks • Symptom onset usually 2-3 weeks for 80-90% of infected patients. • Monitor CD4+ & HIV RNA assay • (standard viral load test)
Pathogenesis • 3 phases • Primary (Acute) Phase • Latent Phase • Early HIV infection • Intermediate HIV infection • Chronic Phase • Late HIV infection • AIDs • CD4+ T cells drop below 200 cells per µL
Pathophysiology • Immediate Th1 and Th2 response • Autoimmunity • Immunodeficiency • Neurological Dysfunction
Documentation • Incident Report • Testing Period • Employee file concerning exposure • Record Keeping • Worker Comp. • Counseling
Something else to think about: "Have you more faith in a spoonful of medicine than in the power that animates the living world?" BJ Palmer