Prevention

There is no vaccine for hepatitis C and preventing infection relies on avoiding the risk factors associated with the transmission of the virus.

Injecting Drug Use

In Australia more than ninety percent of new hepatitis C infections are attributed to unsafe injecting drug use practices. The phrase “use a new fit for every hit” has become relatively well-known, however ALL injecting equipment has the potential to transmit blood borne viruses (such as hepatitis C) if it comes in contact with infected blood. This includes swabs, spoons, water, tourniquets, filters, unwashed hands and flat surfaces. It only takes a microscopic amount of infected blood to get into a person’s bloodstream for infection to take place. Hepatitis C can survive on an open-air surface for up to four days, however inside a protected environment such as the barrel of a syringe, it may live up to thirty days. It is also important to note sharing nasal straws for snorting drugs can potentially create blood-to-blood contact between people.

Tattooing and Piercing

Unsterile equipment or procedures used for tattooing and body piercing can pose a transmission risk. When contemplating body art it is important to access licensed professional studios with sterile practices. Travellers should note that the relatively stringent laws in Australia governing sterile skin penetration procedures are not necessarily reflected in the practice of overseas tattooists and body piercers, particularly in developing countries.

Medically Acquired

The hepatitis C virus was identified in 1989, with screening introduced in Australia early in 1990. Before this time it was possible to acquire hepatitis C through medical procedures and blood products. In earlier decades, the use of non-sterile surgical equipment and cross-contamination from combat has been linked to the first recognised hepatitis C outbreak after World War II.

Household Transmission

Household transmission of hepatitis C is extremely unlikely, although there are a few recommended precautions. Personal grooming items such as toothbrushes, razors, body jewellery and nail clippers should not be shared, as they have the potential to break the skin and carry minute amounts of blood (even if blood is not visible, enough may be present to transmit hepatitis C). Any blood spills should be cleaned up immediately using standard infection control procedures (using latex gloves, antiseptic, disposable paper towels and sealed plastic disposal bags).

Mother to Child

The risk of vertical transmission from mother to baby at birth is estimated to be around five percent, providing the mother is not co-infected with HIV or has an unusually high hepatitis C viral load. In this case, the risk of transmission would be a little higher. If a pregnant woman is aware of her sero-status, it is important medical staff are advised before delivery so an instrument-free birth can occur. Vaginal delivery with the use of forceps has been shown to be the main risk factor for transmission. A caesarean delivery is not considered necessary if the mother has hepatitis C as reducing the risk of skin damage to a baby during birthing significantly reduces the risk of transmission to the baby.

It is safe to breast feed if the mother is living with hepatitis C, as viral quantities found in breast milk are not high enough for transmission. However, if the mother has bleeding or cracked nipples, there is a risk of blood-to-blood contact with the baby.

Sexual Transmission

Hepatitis C is not considered a sexually transmissible infection, as it is not present in sexual fluids in quantities large enough to allow transmission. Caution should be exercised where skin trauma can occur. This includes anal intercourse, rough sex, the use of sex toys or where a partner has a condition causing skin irritation in the genital area. To minimise the risk of infection condoms, dental dams and gloves should be used where appropriate. A water-based lubricant is also helpful in reducing skin damage.

Needle Stick

Transmission of hepatitis C through needle stick injuries is extremely rare. It is estimated there is a two to eight per cent risk of hepatitis C transmission for people potentially exposed in this way in health care settings. There is even less chance of contracting hepatitis C from a needle-stick injury in the community.

References
Farrell, G (2002) Hepatitis C, other liver disorders and liver health: a practical guide
http://www.hepatitiswa.com.au/