CLINICAL LAB SCIENEC

CHAPTER 6: INTRODUCTION TO INFECTION CONTROL 135
before the appearance of symptoms and that it persists even after successful treatment
has alleviated the initial symptoms. It should be noted that a person who
has been successfully treated may appear normal while continuing treatment but
may be able to infect others. Therefore, preventive measures in relation to sexual
practices and performance of medical procedures should always be taken.
Prevention and control of HIV infection go hand in hand. Because most
cases are transmitted sexually or by shared using of drug paraphernalia, these
practices must be modified or curtailed by those who are positive for HIV. Good
rules to follow are to avoid indiscriminate sexual contact with new partners,
particularly those whose background is unknown and to avoid the use of IV
drugs and the sharing of IV drug items. In the health care facilities and when
treating patients at the sites of accidents, scrupulously careful cleaning and disinfection
of blood and body fluid spills are necessary to avoid the spread of
the virus. Cleaning practices should include protection for the person responsible
for cleaning contaminated area such as those where medical procedures have
been performed that generate blood or other body fluids and tissues. Protective
aprons or other clothing impervious to liquids, such as safety aprons, should be
worn over the clothing normally worn for work, along with reusable gloves that
are in good condition and that are cleaned between uses.
Medical laboratory technical personnel are encouraged to clean their work
surfaces and equipment frequently with a fresh 10% bleach (Clorox or sodium
hypochlorite) solution. This is the most effective disinfectant that is readily available
and should be made fresh on a daily basis. Surfaces and objects contaminated
with blood or body fluids that may contain blood (e.g., vomitus or urine )
must be cleaned with detergent and water and disinfected immediately. The disinfecting
solution of household bleach and water at a 1:10 ratio is extremely
effective against HIV and almost all other viruses and bacteria.
For effective cleaning of work surfaces, a procedure should be followed in
which fresh 10% bleach solution is used to generously saturate the area and then
the surface is allowed to air dry. DO NOT RINSE. The solution loses its potency
within a few hours so it should be prepared fresh daily. Some medical facilities
use materials other than bleach and use additional procedures for disinfecting all
surfaces within the clinical areas. Policies for disinfecting areas are published in a
facility’s policy and procedure manual and will be documented as being effective
by the Infection Control Committee before the procedure is adopted.
HIV may be found in conjunction with other infectious organisms, because
of the immunocompromised condition of the patient seeking treatment, which
gives other microorganisms the opportunity to grow. It is important to test accident
victims following treatment where a number of medical responders may
have been exposed to the victim’s blood.
HIV and other potentially dangerous organisms may be found in body fluids
even when there are no symptoms to suggest infection is present. Some HIVinfected
persons are diagnosed during routine testing, and show no signs or
symptoms of infection. A person with an HIV infection ultimately develops a
weakened immune status and thus is also vulnerable to a host of opportunistic
infections with organism not normally found as human pathogens. These
patients may require reverse isolation to protect them from exposure to others,
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