[Question #4245] HTLV 1 and 2 - indirect/casual transmission possible?

31 months ago
Hello Drs, I very much hope you can help with this.

I just came across this on CNN about HTLV which frankly I hadn't heard of before (the CNN article says it is now classified as an STI) - https://edition.cnn.com/2018/05/07/health/htlv-1-virus-australia-explainer/index.html?no-st=1536645706

I searched this forum hoping to get some more details, and I saw in one of your more recent responses you said you were not experts on HTLV transmission. However I'm hoping my question is sufficiently basic that you can answer with confidence in your response, and that it is with up-to-date understanding etc.

I saw another poster mentioned various medical conditions/medications and asked if they could increase the risk of HTLV 1 or 2 transmission - I am in a similar place, in that myself and family members suffer from one or more of the below conditions. However in my case the only potential exposure myself and my family could have had would be via indirect or casual contact, i.e. through touching surfaces or using a hotel room/Air BnB that had been inadequately cleaned, so my question is whether this is a risk?
The expert in the CNN article says there is never a risk of indirect/casual transmission, but I'm worried whether this still applies if someone has a particular medical condition etc? We have been on holiday to places like Australia, South America, Japan/Korea, and the Caribbean. So I'm now really worried my family might have been exposed to either HTLV 1 or 2 through staying in an inadequately cleaned Air BnB, or through having dinner with locals at a restaurant? My only worry is whether medical conditions like the below would be an 'exception to the rule' that these viruses are not transmitted casually/indirectly?

Please can you help with this, I am not sure which other forum to turn to (and the CNN article does call this an STD). Hopefully the fact this is a basic question means you can still answer as experts on epidemiology/infectious diseases? I.e. are HTLV 1 & 2 never transmitted casually/indirectly, regardless of medical conditions?

Example conditions-
Immune thrombocytopenic purpura (ITP)
Bronchiectasis/COPD/asthma/bronchitis/respiratory
High-dose long-term steroid/oral steroid
Von Willebrand and other blood clotting disorders
Diabetes / varicose veins
Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Welcome to the Forum.  HTLV 1&2 are spread through DIRECT exposure to blood and blood products (such as through transfusion of unscreened blood [all blood in the U.S. is screened for HTLV]) or sexual contact.  It is even less common than HIV and is seen most commonly in the Crribean, Latin America and the Far East.  The infection is not transmitted by casual contact including residing in a room which was cleaned or stayed in by a person with HTLV, not by touching, and not by ingestion of contaminated food.  None of the conditions you lest increase susceptibility to HTLV.  Nothing you mention in your post suggests any reason for concern.  EWH
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31 months ago
Thank you Dr Hook that is so helpful, I feel so reassured already. I really can’t thank you enough Dr.

So I know I’ve understood you, please could I also ask:

A) You mention there was no risk of transmission from staying in a cleaned room if someone had been in there previously with HTLV 1/2, what about a room poorly cleaned/not cleaned? I assume your advice is still the same?

B) You said these conditions would not increase risk of HTLV transmission, which is very helpful to know. Are there any other conditions that would increase risk of HTLV 1 & 2 transmission via casual (ie social contact in a restaurant etc) or indirect contact? (indirect contact including staying in poorly or uncleaned room etc)
Or am I right to think there are no exceptions to the advice in the CNN article that HTLV 1 & 2 are never transmitted through casual or indirect contact?

C) In a recent response to another poster, Dr. Handsfield said he & yourself were not HTLV experts, which I accept.
However is it the case that given how straightforward my questions are, the answers are something an epidemiologist/infectious disease specialist would know - and so can be considered fully up-to-date/accurate etc?

Thank you again Dr. Hook




Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
Your questions are repetitive.  The answers will not change:
A) You mention there was no risk of transmission from staying in a cleaned room if someone had been in there previously with HTLV 1/2, what about a room poorly cleaned/not cleaned? I assume your advice is still the same?
Correct

B) You said these conditions would not increase risk of HTLV transmission, which is very helpful to know. Are there any other conditions that would increase risk of HTLV 1 & 2 transmission via casual (ie social contact in a restaurant etc) or indirect contact? (indirect contact including staying in poorly or uncleaned room etc)
Or am I right to think there are no exceptions to the advice in the CNN article that HTLV 1 & 2 are never transmitted through casual or indirect contact?
No exceptions

C) In a recent response to another poster, Dr. Handsfield said he & yourself were not HTLV experts, which I accept.
However is it the case that given how straightforward my questions are, the answers are something an epidemiologist/infectious disease specialist would know - and so can be considered fully up-to-date/accurate etc?
Yes, these are accurate answers to your question.
EWH
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31 months ago
Great thank you again Dr.   Sorry for asking obvious questions, it’s really helped to reassure me however.

1. One other question (although I think this is again obvious) - the CNN article says there would be no risk if a person shared a towel with an HTLV 1 or 2 infected person. Am I right to assume again there are no exceptions to this due to any medical conditions/medication?

2. I’m right to think all your responses apply to HTLV generally, eg whether HTLV 1 or 2 etc?


Thanks again Dr, really appreciate it.






Edward W. Hook M.D.
Edward W. Hook M.D.
31 months ago
1.  Correct.  No risk from a shared towel
2.  Correct, my responses are relevant for both HTLV-1 and HTLV-2.

This is my 3rd response to your questions, thus, as per Forum Guidelines, this thread will be closed shortly with no further responses.  Please do your best to put your concerns behind you.  There is nothing you have said to suggest that you are at risk for either type of HTLV.  EWH
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