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Clinical picture
The hepatitis C virus (HCV) can cause liver inflammation (hepatitis). Most acute HCV infections cause no symptoms or only mild, non-specific symptoms. Only 30-50% of patients report fatigue, mild flu-like symptoms, nausea, vomiting, dark urine and/or discolored stools, and abdominal pain. Without treatment, 15-40% of HCV-infected individuals manage to get rid of the virus within 6 months. The remaining 60-85% become chronic carriers of the virus.
Route of infection
Hepatitis C infection occurs through contact with contaminated human body fluids on broken skin or mucous membranes caused by puncture wounds, splashes, cuts, and bites.
Contagious period
The blood of an HCV-infected person is infectious as long as the virus (HCV RNA) is detectable in the blood. This can be the case as early as 1 week after infection.
Incubation period
Time between infection and symptoms: 7 weeks on average, ranging from 2 to 26 weeks.
Risk of infection
There is a risk of infection if there is contact with blood or other bodily fluids through needle stick, splash, cut, or bite accidents. The described chances of transmission in the event of a needle stick injury with HCV-positive blood vary from 0 to 10%, depending on the type of needle stick accident. See the National Guideline on Needlestick Accidents. It is estimated that there is a 1.9% chance of HCV transmission per needlestick accident; this is lower than for HBV and higher than for HIV.
Increased risk of (work-related) infection
(Para)medical personnel (including dentists) who perform many invasive procedures (e.g., gynecologists) have an increased risk of infection with HCV.
Increased risk of severe progression
- At an older age at the time of infection.
- Chronic liver disease and (former) injecting drug users.
- HIV-positive individuals.
- Dialysis patients.
- In the event of co-infection with HIV or hepatitis B.
Risk of further spread
(Para)medical personnel who perform many invasive procedures (e.g., gynecologists).
Protective measures
- Needle systems equipped with a safety mechanism that (automatically) shields the used needle.
- Needle container within reach.
- Safety goggles, face protection, disposable gloves.
Policy after unprotected exposure
Allow the wound to bleed freely and rinse with water or saline solution. Then disinfect the wound with a skin disinfectant. In case of contamination of the mucous membranes, rinse immediately and as thoroughly as possible with water or saline solution.
Follow the protocol of the healthcare institution where you work. Contact the company doctor/expert responsible as soon as possible, and in any case within two hours, after accidental blood contact (by telephone).
Every organization where employees may be exposed to HCV must have a protocol for needlestick, splash, cut, and bite accidents that stipulates that an employee can consult an expert 24 hours a day for a risk assessment of the incident and the necessary follow-up steps as described in the National Guideline on Needle Stick Accidents issued by the RIVM.