[Question #9598] HPV Risk Medical Procedure
 |
31 months ago
|
Hello Doctors:
(23, M.) I had completed an upper endoscopy procedure. I was the 2nd patient of my doctor that day. While the doctor was briefing the results, I heard that the patient before me (the 1st patient) had a tumor in his throat which could be cancer.
Although cancer itself isn't infectious, recently I learnt HPV causes 70% of throat cancers. So here I am, having been worried since the patient before me potentially carries HR-HPV in his throat.
1. If the doctor or nurse who handled or touched the endoscopes did not change gloves in between patients, then touched the new scope for my procedure with the contaminated gloves
(i.e., contaminated endoscope - gloves - new scope - my throat/esophagus/stomach...)
Am I at risk for infection? The scope rubbing the patient's throat is contaminated, and gloves touch the contaminated scope while pulling in and out, and touch the new scope.
2. The patient before me had already developed throat tumor. Does this mean his infected site (throat) carries a higher HPV viral load? More virus would be left on scope / touched by gloves, leading to a higher risk for transmission?
3. I read in your other responses that there has to be DIRECT contact for HPV to transfer.
Studies have found HPV in stomach/gastric tissues in 28% of the over 2000 patients, indicating it a potential risk for gastric cancer.
From your experience, how is it possible to find HPV in the stomach?
Thank You!!
 |
Edward W. Hook M.D.
31 months ago
|
Welcome to the forum. Thanks for your questions. I'll be glad to comment. As a generalization, the risk for acquiring HPV from a medical procedure such as endoscopy performed by a medical professional is extraordinarily low and not something to concern yourself. I'll address your specific questions below but please remember, in the reference only about one in four gastric cancers were found to contain HPV DNA, health care providers always change gloves between patients, and health care providers do not tend to touch biopsy materials collected during medical procedures. I have never heard any suggestion that HPV might be transmitted in the manner you describe. It is certainly not something I would worry about. With this, let's address your specific questions:
1. If the doctor or nurse who handled or touched the endoscopes did not change gloves in between patients, then touched the new scope for my procedure with the contaminated gloves
(i.e., contaminated endoscope - gloves - new scope - my throat/esophagus/stomach...)
Am I at risk for infection? The scope rubbing the patient's throat is contaminated, and gloves touch the contaminated scope while pulling in and out, and touch the new scope.
Please see my comment above. I am confident that there is no risk of transfer of material from the patient who proceeded you to you.
2. The patient before me had already developed throat tumor. Does this mean his infected site (throat) carries a higher HPV viral load? More virus would be left on scope / touched by gloves, leading to a higher risk for transmission?
No. When HPV related tumors develop, it is because tiny amounts of HPV DNA is incorporated into a person's cells. If any thing the viral load associated with tumors is low
3. I read in your other responses that there has to be DIRECT contact for HPV to transfer.
Studies have found HPV in stomach/gastric tissues in 28% of the over 2000 patients, indicating it a potential risk for gastric cancer.
Correct. There is no meaningful risk for acquisition of HPV from another patient during endoscopy.
Please don't worry. EWH
--- |
31 months ago
|
Hello Dr. Hook,
I too believe that the doctor would always change gloves in between endoscopy patients : )
It's just sometimes I kept thinking about the worst case scenario, like if the nurse (who remove used endoscope and install new one) did not 100% follow protocol or change gloves in this process, etc. etc.
1. If we assume this is the case, is there a risk?
(i.e., contaminated scope - gloves (or whatever medium) - new scope - my throat/esophagus/stomach)
2. Does HPV also require a certain amount of virus particles to be transmissible?
Maybe it explains why indirect contact does not cause infection, because virus particles through indirect contact are to low?
Thank you for addressing my concern!
|
Edward W. Hook M.D.
31 months ago
|
Your anxiety is getting the best of you. Even if a nurse failed to follow protocol, which I am confident did not happen, there would still be no risk of infection with HPV.
Infections occur with what is called a "dose-response" meaning that the higher the dose (or number of viral particles), the more likely a result is to occur. Think of it as being like a lottery- the more lottery tickets one purchases, the more likely one is to win. Similarly, the more viral particles a person is exposed to the more likely infection is to occur.
You are worrying needlessly. EWH
--- |
31 months ago
|
This is my last question in this thread:
So Even If a nurse handling the endoscope did not follow protocol / change gloves and contaminated the new scope...
There is still NO risk?
May I ask why? What's the logic behind this?
(I thought if a glove / medium touched the used scope with HPV virus, then touched the new scope, some virus particles may be brought onto the new scope...)
Is it because the "dose" through indirect contact being too small for infection to occur?
I have some anxiety issues that comes and goes. Your expertise and responses have been reassuring. Thank you again!!
|
31 months ago
|
The hospital was not in the US, that's why I worried "If nurse not following protocols/changing gloves..." : )
|
Edward W. Hook M.D.
31 months ago
|
Final responses.
As you quoted us before, HPV is transmitted by DIRECT contact and is not meaningfully transmitted on an individuals hands or foreign bodies. Please review my earlier responses.
The fact that this did not occur in the U.S. does not change my assessment.
This completes this thread. Please don't worry. EWH
---