[Question #12577] Risk to my child
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6 months ago
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My daughter felt the urge to pee. Went to the public toilet near bus stand. It was an INDIAN toilet (SQUAT toilet). For female to urinate in Indian toilet, she needs to sit in squat position resting her both foots on the footrests on both side of the sink. Got lil busy with phone, by dat time my daughter went inside toilet and lowered her trouser and sat in SQUAT position to pee. I was shocked to see BLOOD in an ELLIPTICAL shape near her right foot. Blood would have been around 4 drops(Wet Blood) on footrest of the toilet (towards inner side) at Distance of 1 CM from her foot. As she started urinating, the blood got washed down the sink by urine. She was wearing slipper, however half her foot was not covered due to the slipper design. Also the trouser was not covering her lower leg portion near and the thigh portion.
At times she gets pimple like slightly raised itchy wound and often she itches it and at times it pops up and bleeds. HOWEVER I DID NOT CHECK WHETHER SHE HAD SUCH ITCHY WOUNDS OR NOT THAT DAY AND WHETHER SHE ITCHED IT OR NOT.
Question 1.What is the risk of hiv if some blood droplets splashed on her feet and leg.
2.What if some drops splashed to vagina and anal area
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6 months ago
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3.I forgot to wash her feet and after reaching hotel around 4-5 hours later, my wife bathed her. Does it make any difference in risk.
4.Can I forget this incident and move on without any worry.
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H. Hunter Handsfield, MD
6 months ago
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Welcome to the forum. I'm happy to address these questions. The bottom line is good news: there has never been a known case of HIV transmitted on account of exposure to toilets of any kind. While I've not seen reports specifically of Indian style facilities, I am sure that if such cases were known in that country they would have had world wide notice by medical resources, scientific literature, and public health agencies. There have been none. In addition, I'll point out that people who share households with HIV infected persons never are infected even after years of sharing toilets, kitchens, towels, and the like.
Why no risk? First, simply getting HIV infected blood or body fluids on the skin does not transmit the virus, even in the presence of skin cuts, rashes, pimples, etc. The very reason HIV is very limited to certain high risk populations is that the virus is very difficult to transmit: large amounts of virus must have direct contact with large numbers of certain kinds of cells that generally are deep inside the body. Whether or not your child had "itchy wounds" of her skin makes no difference. Likewise, fluids simply splashing onto the anus or vaginal opening is no risk for HIV. (Similarly, there is no risk of any other STI.)
Those comments pretty well answer your specific questions, but to be explicit:
1. "What is the risk of hiv if some blood droplets splashed on her feet and leg.?" None.
2. "What if some drops splashed to vagina and anal area?" Same answer.
3. "I forgot to wash her feet...." It's common sense hygiene for all humans to wash after potential contact with other persons' blood, feces, urine, etc. From being in India, you undoubtedly know that in many communities just walking down the street involves walking in animal and sometimes human waste. But the reason for washing is not HIV or STIs: it's to protect against various non-STI viruses and bacteria.
4. "Can I forget this incident and move on without any worry." That is exactly what you should do.
I hope these comments are reassuring. Let me know if anything isn't clear.
HHH, MD
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6 months ago
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Thank you doctor for your response and it has helped me a lot.
I want to ask some more question:-
1.What type of blood exposures are risky and which type of cut/break in skin is required for the virus to have access to the susceptible cells. I mean how fresh , how much large and how much deep a cut and wound is required for blood exposure that might take place APART from sharing drug injection equipment, blood transfusion and injuries to medical personnel.
2.If scab is formed on a cut/wound, is there any risk if some contaminated blood contact it.
3.I am getting some what if scenarios related to the event that I described in my question. What if some blood droplet might have splashed onto a itched pimple wound and then while walking back to the car that blood might have been rubbed against the itched pimple wound by the slipper. Is there a risk in this scenario.
4.So your final advice to me related to the event that happened with my daughter as detailed in original question.
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H. Hunter Handsfield, MD
6 months ago
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Common public education advisories about HIV probably are partly responsible for your fears about blood exposure and HIV. Often they just say "blood exposure" without providing any further detail. But the fact is that except from shared drug injection needles, very few HIV infection result from blood exposure. It's a very rare problem.
2. Exposure of a healing or scabbed would is little or no risk for HIV.
3. I cannot think of any blood exposure scenarios in someone's toilet experience that would significantly risk catching HIV.
4. My final advice is the same as above. As you said yourself, that you "forget this experience and move on without any worry."
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6 months ago
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So my daughter's exposure belongs to which risk category
1.NO RISK EXPOSURE
2.NOT A SIGNIFICANT EXPOSURE
3.LITTLE OR NO RISK EXPOSURE.
I am asking this just to be explicit because if my daughter's exposure fall into 2 or 3 category of exposure then there is some risk, which means testing is required to rule out.
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6 months ago
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In my daughter's case , can a scabbed wound /healing wound be considered a risk given the type of exposure.
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6 months ago
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When you said "Exposure of a healing or scabbed would is little or no risk for HIV.".Did you refer to large blood exposure like helping auto accident victims only or the sort of exposure that my daughter have had as detailed earlier
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6 months ago
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I have read your comment or dr hook's comment that if a wound is no longer bleeding, then it is not a risk. Also somewhere you mentioned that if there is blood exposure within couple of minutes of being injured, then it is a risk, otherwise it is not a risk. That's why I am specifically concerned about your comment on healing/scabbed wound. It would be highly appreciable if you could answer these questions as this is my 3rd and hence last follow up question
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6 months ago
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Sorry sir for the nature of my questions... I am currently dealing with heightened level of anxiety and will soon start my counseling related to my mental health.
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H. Hunter Handsfield, MD
6 months ago
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The opportunity for follow-up questions are to clarify any uncertainties after the initial question, not to raise entirely new anxiety driven issues.Your mind is working way overtime to point of serious obsession. And the answers to these assertional questions are obvious from my previous replies. "Which risk category?" No risk, as I already said repeatedly. Did you think I might have changed my mind? Scabbed wound: already answered; read above.
You cannot read replies to questions other than your own and assume the details apply to your situation. Nobody in the world has ever been known to catch HIV from the kinds of exposures you are repeatedly asking about.
Be aware of the forum policy against repeated anxiety driven questions. Please do not return with any more questions about your daughter's toilet experience or questions about wound exposure to blood. Thank you.
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