[Question #5951] Q #5532 follow-up (household transmission inc children)

71 months ago

Dear Drs,

I read on here sometime ago from another poster that living with a roommate or family member (so no sexual relations) and sharing razors/toothbrush/towel/other household objects over a 2-3 month period, would have <1% chance of transmission of HIV/Hep B/Hep C and any other STDs/bloodborne disease. This was assuming the person is high-risk/infected with the bloodborne disease/STDs.

I’m in a similar situation to another poster where his gf lived with him and his family for 2-3 months, from a high-risk country. None of the family are vaccinated against HBV or any other STDs/blood borne viruses.

Myself and my family suffer from DCD (Developmental Coordination Disorder), also known as dyspraxia.

I posted previously on this (Q #5532) and received a great deal of reassuring info from Dr Handsfield.

However I thought about this some more and wanted to follow up on this:

1. Would the advice in Q5532 still apply to contact with children? (5yrs+ old). To be clear, this is not living with children - rather, my high-risk gf visited our relatives a couple of times and had normal interactions with my young (5yrs+) cousins, playing games with them (playfighting etc)

2. Am I correct to say the overall probability of such interactions (play fighting etc) from a single day visit with 5yr+ old children, causing transmission of HIV/Hep B/Hep C and any other STDs/bloodborne disease, would be >10,000 to 1? Or would it be higher, say >100,000 to 1? I am just looking for a conservative idea here to get an estimate of how often this occurs through such casual/environmental contact. This is assuming the high-risk person (my gf) was infected

3. As mentioned my family (including my relatives/their young children) suffer from DCD. Also one of my young cousins has Crohn’s disease. Am I right however that such medical conditions would have no material impact on the likelihood of transmission, and as such would not change the answers to 1 & 2?

Thank you again kind Drs

H. Hunter Handsfield, MD

71 months ago

Welcome back, but sorry you found it necessary. I reviewed our previous discussion and would not change any of the advice I gave at that time.

I will repeat that there are no known cases of HIV transmission in households assuming no sex or other overt blood exposure, like sharing needles for drug injection. I discussed this in detail in my first reply in your previous thread; please re-read it.

1) Yes, those statements and all the other comments I made apply to children. No children ever catch HIV in households, if no sexual abuse, and no HIV infected children infect adults.

2) The same applies to hepatitis B virus and other blood borne infections. HBV is more easily transmitted than HIV, but still there the risk is misiscule for this and other blood borne viruses with normal child care and common sense hygiene. The risks for any single visit or contact probably is far lower than the fitgures you give. In any case, all children are supposed to be vaccinated against HBV, and the adults in the family should consider it as well. Once vaccinated, of course any risk of HBV is zero.

3) We discussed this last time. I still see no reason your DCD would have any effect on transmission risk.

The nature of your questions suggests you are irrationally obsessed with all this. I'm inclined to believe you have OCD in addition to DCD. Has that been a problem for you? Seems to me you might benefit from a discussion of such risks with the doctor(s) responsible for your and the family's DCD, and perhaps with a counselor about OCD. It truly is not normal to remain so irrationally frightened after the repeated, reasoned, science-based reassurance you have had -- at least on this forum, and perhaps from your own doctors. I suggest it from compassion, not criticism.

In the meantime, try not to worry! Blood borne infections simply should not be a significant worry for you, regardless of your dyspraxia.

I hope these comments are helpful. Best wishes.

HHH, MD

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71 months ago

Thank you Dr that is so very reassuring. So just to be clear could I please ask:

1. When you say the overall risk is lower than the numbers I’ve stated, this would apply to the 1 in 100,000 number? That is with my gf (assuming she is infected with STDs/bloodborne disease such as Hep B/Hep C/HIV/syphillis etc) spending one or two days with relatives and play-fighting etc with my 5yrs+ old cousins?

2. We are in a country without routine HBV vaccination - so none of us have ever been vaccinated against HBV or any other STDs/bloodborne. But I assume that doesn’t change your answers?

3. Thank you for clarifying on DCD. One of my young cousins also has Crohn’s disease, would this (or any other medical condition/medication) change your previous answers?

4. When you say bloodborne disease, I’m right in thinking this applies to any bloodborne e.g HTLV and HHV-8? I know they’re not STDs specifically but hoping you could reassure me based on your expertise/knowledge as an infectious disease specialist.

Thank you so much for your reassurance again Dr.

H. Hunter Handsfield, MD

71 months ago

1) All such numbers are little more than guesswork, but yes: I would guess the risk to be well under 1 in 100,000.* As for "assuming" your gf has one of those infections, that's wacko! If there is reason to suspect she has such an infection, she should be tested and so should you. Any risk to you and her is infinitely higher than from visitors who may or may not be infected! But in no way is she a risk to the children.

2) There is no country that does not have HBV vaccination available. (Where are you?)

3) There are no medical conditions you can think of that would change my opinions or advice. Certainly Crohn's disease would inot increase risk.

4) Yes, I mean all blood borne infections including HTLV and HHV8.

* You need to get a grip on numerical risks of life. This really is a pointless discussion! According to the National Safety Council, if you live in the US there is 1 chance in 1,756 you will die in the next 12 months of an accident (auto wreck, drowning, fall, etc, etc).That means the chance you'll be gone in the next year is 57 times higher than 1 in 100,000. If you're in a less developed country, these risks probably are even higher. So my advice is to stop worrying about trivial issues like this -- and don't forget your seatbelt when driving! If you still don't get it, that simply reinforces my advice about professional counseling.

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71 months ago

Thanks again Dr, sorry this is my last set of questions. Thank you again for all your reassurance:

1. On your last response #1, I appreciate you pointing out I should not be worried. But just to be clear, when you say the odds are likely considerably lower than 1 in 100,000 - would it be correct to assume you mean the odds are likely closer to 1 in 1,000,000 than 1 in 100,000?

As you say I understand it is a low risk, however nonetheless clarifying this would give me the final reassurance.

2. On your response to #2 - sorry I should have been clearer, I am in a Western European country which has the HBV vaccine available, but it is not freely offered and as such neither myself, my girlfriend or any of my family/relatives/5yrs+ old cousins have ever been vaccinated. However am I right this doesn’t change any of your previous answers?

Thank you once again Dr for all your kind help.

H. Hunter Handsfield, MD

71 months ago

Sorry, I have no further comment and will not play this silly game. Obviously it makes no difference if the odds are anywhere in the range you ask about.

Correct, not being vaccinated does not change my replies.

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the two discussions have been useful.

Please note the forum does not accept repeated questions on the same topic. This being your third about these concerns, it will have to be your last. Future new questions will be deleted without reply and without refund of the posting fee. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thank you for your understanding.

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