AD 2017 Q4

RESEARCH, EDUCATION & MEDICINE
EXPERT OPINIONS
that a dive team take whatever
steps are necessary to ensure that
the presence of HCV in any team
member would not cause a second
thought or require modification of
an action plan.
Considering the elevated risk of
public safety dive missions, strong
consideration should be given to
prioritizing training, and teams
should accept the extra burden of
screening and meticulous cleaning
of shared equipment.
Gish: The most important
measure would be to minimize
blood exposure from the infected
individual to anyone who may
have breaks in their skin where
some type of direct contact could
theoretically take place.
Sampath and Mangum:
According to the CDC, HCV is
primarily transmitted through
large or repeated percutaneous
exposure to blood but is also
spread infrequently through
sharing of personal items such as
razors or toothbrushes. Diving
carries the risk of exposure to
blood and body fluids.
Minimizing the sharing of
personal equipment and using
pony bottles rather than buddy
breathing would be good practices
for divers with HCV. As in other
settings, first aid for injuries in the
diving environment should involve
standard precautions (e.g., fluid
barriers such as nitrile gloves). Divers
with HCV should be particularly
cautious about sharing equipment
and forthright about disclosing their
infection when there are sores or
blisters in their mouths, as these
could lead to blood exposure if
equipment is shared. AD
STEPHEN FRINK
MEET THE EXPERTS
Robert Gish, M.D., FAASLD, is a hepatologist and a clinical professor of transplant
surgery at the University of Nevada, Las Vegas, as well as a consulting professor of
medicine at Stanford Hospital and Medical Center.
Nick Homa, Ph.D., studies human pathogens and infectious disease in the Department
of Molecular Genetics and Microbiology at Duke University School of Medicine.
Lisa Magnum, FNP, practices internal medicine, travel medicine and infectious
disease at Blue Ridge Infectious Disease in Morganton, N.C.
Richard Sadler, M.D., FACS, CHT, is a general, vascular and thoracic surgeon based
in Davenport, Iowa; a certified hyperbaric technician; and an avid technical diver. He
specializes in undersea and hyperbaric medicine and is the medical director for Dive
Rescue International.
Rahul Sampath, M.D., an internal medicine and infectious disease specialist, is the
head of Blue Ridge Infectious Disease in Morganton, N.C.
56 | FALL 2017