Blood Borne Infections
(including HIV& Viral Hepatitis)
diseases (STDs) or more recently sexually transmitted infections
(STIs) are diseases that have a significant probability of transmission
between humans by means of human sexual behavior, including vaginal
intercourse, anal sex, and oral sex.
Some STIs can also be transmitted via the use of IV drug
needles after its use by an infected person, as well as through
childbirth or breastfeeding.
sexually transmitted infections have been well known for hundreds
of years. Others like HIV and viral hepatitis have becaome more
prevalent in recent times but they are all endemic world wide but
are usually more prevalent in certain overseas destinations.
Sexually Transmitted Infections
- Viral Hepatitis
- Genital Herpes
- Pelvic Inflammatory Disease
- Pubic Lice
If a traveller indulges
in casual sex, the risk of infection with
a sexually transmitted disease is high.
Gonorrhoea and syphilis may cause serious long-term disability,
especially if treatment is delayed. Chlamydia is widespread throughout
many countries including European countries and the UK and is often
symptomless and goes unnoticed for some time. If untreated it can
result in sterility. Hepatitis B and HIV are both also spread sexually
and there is currently no cure for either infection.
Travellers should be aware that a person infected with an
STD, HIV or Hepatitis B may appear perfectly healthy and may not
even know that they are infected.
sexual intercourse is risky. Unprotected sexual intercourse
should avoided with anyone other than a regular partner. Always
use good quality condoms and carry them rather than try to obtain
them at the last minute. Remember, condoms provide good but not
Alcohol weakens inhibitions and makes it easier to forget about
Any person who on return from travel has any reason to believe
that they may have picked up an infection should get a thorough
check up at their local VD clinic.
Whilst all STIs are potentially dangerous,
the three most common (Chlamydia, Gonorrhoea & Syphilis)
are dealt with in more depth here:
Chlamydia is a common sexually transmitted disease caused by the
bacterium, Chlamydia trachomatis, which can damage a woman's reproductive
organs. Even though symptoms of chlamydia are usually mild or absent,
serious complications that cause irreversible damage, including
infertility, can occur "silently" before a woman ever
recognizes a problem. Chlamydia also can cause discharge from the
penis of an infected man.
is the currently most frequently reported bacterial sexually transmitted
disease in Western Countries. Under-reporting is substantial because
most people with chlamydia are not aware of their infections and
do not seek testing.
Chlamydia can be transmitted during vaginal, anal, or oral sex.
Chlamydia can also be passed from an infected mother to her baby
during vaginal childbirth.
sexually active person can be infected with chlamydia. The greater
the number of sex partners, the greater the risk of infection. Because
the cervix (opening to the uterus) of teenage girls and young women
is not fully matured and is probably more susceptible to infection,
they are at particularly high risk for infection if sexually active.
Since chlamydia can be transmitted by oral or anal sex, men who
have homosexual sex with other men are also at risk for chlamydial
Chlamydia is known as a "silent" disease because the majority
of infected people have no symptoms. If symptoms do occur, they
usually appear within 1 to 3 weeks after exposure.
Women who have symptoms might have an abnormal vaginal discharge
or a burning sensation when urinating. If the infection spreads
from the cervix to the fallopian tubes they may develop lower abdominal
pain, low back pain, nausea, fever, pain during intercourse, or
bleeding between menstrual periods. Chlamydial infection of the
cervix can spread to the rectum.
with signs or symptoms might have a discharge from their penis or
a burning sensation when urinating. Men might also have burning
and itching around the opening of the penis. Pain and swelling in
the testicles are uncommon.
Men or women who have receptive anal intercourse may acquire chlamydial
infection in the rectum, which can cause rectal pain, discharge,
or bleeding. Chlamydia can also be found in the throats of women
and men having oral sex with an infected partner.
If untreated, chlamydial infections can progress to serious reproductive
and other health problems with both short-term and long-term consequences.
Like the disease itself, the damage that chlamydia causes is often
Untreated infection can spread into the uterus or fallopian tubes
and cause pelvic inflammatory disease. Chlamydia can also cause
fallopian tube infection without any symptoms but can lead to chronic
pelvic pain and infertility.
among men are rare. Infection sometimes spreads to the epididymis
(the tube that carries sperm from the testis), causing pain, fever,
and, very rarely, sterility.
Babies who are born to infected mothers can get chlamydial infections
in their eyes and respiratory tracts.
Chlamydia can be easily treated and cured with antibiotics. A single
dose of azithromycin or a course of doxycycline are the most commonly
All sex partners should be evaluated, tested, and treated. Persons
with chlamydia should abstain from sexual intercourse for 7 days
after a course of antibiotics to prevent spreading the infection
to their partners.
Gonnorhoea is caused by a bacterium Neisseria gonorrhoeae,
that can grow and multiply easily in the warm, moist areas of the
reproductive system. It can also grow in the mouth, throat, eyes,
Gonnorhoea is a very common infectious disease and is spread through
contact with the penis, vagina, mouth, or anus. Ejaculation does
not have to occur for gonnorhoea to be transmitted or acquired.
It can also be spread from mother to baby during delivery.
sexually active person can be infected with gonnorhoea. People who
have had gonnorhoea and received treatment may get it again if they
have sexual contact with an infected person.
Some men with gonnorhoea may have no symptoms at all. However, most
have signs or symptoms that appear one to fourteen days after infection.
Symptoms and signs include a burning sensation when urinating, or
a white, yellow, or green discharge from the penis. Sometimes men
with gonnorhoea get painful or swollen testicles.
women, the symptoms of gonnorhoea are often mild, but most women
who are infected have no symptoms. Even when a woman has symptoms,
they can be so non-specific as to be mistaken for a bladder or vaginal
infection. The initial symptoms and signs in women include a painful
or burning sensation when urinating, increased vaginal discharge,
or vaginal bleeding between periods. Women with gonnorhoea are at
risk of developing serious complications from the infection, regardless
of the presence or severity of symptoms.
Symptoms of rectal infection in both men and women may include discharge,
anal itching, soreness, bleeding, or painful bowel movements. Rectal
infection also may cause no symptoms. Infections in the throat may
cause a sore throat, but usually causes no symptoms.
Antibiotics can successfully cure gonnorhoea in adolescents and
adults. However, drug-resistant strains of gonnorhoea are increasing
in many areas of the world and successful treatment of gonnorhoea
is becoming more difficult.
Syphilis is a sexually transmitted disease (STD) caused by the bacterium
Treponema pallidum. It has often been called "the great imitator"
because so many of the signs and symptoms are indistinguishable
from those of other diseases.
is passed from person to person through direct contact with a syphilis
sore. Sores occur mainly on the external genitals, vagina, anus,
or in the rectum. Sores also can occur on the lips and in the mouth.
Transmission of the organism occurs during vaginal, anal, or oral
Pregnant women with the disease can pass it to the babies they are
carrying. Syphilis cannot be spread through contact with toilet
seats, doorknobs, swimming pools, hot tubs, bathtubs, shared clothing,
or eating utensils.
infected with syphilis do not have any symptoms for years, yet remain
at risk for late complications if they are not treated.
Although transmission occurs from persons with sores who are in
the primary or secondary stage, many of these sores are unrecognized.
Thus, transmission may occur from persons who are unaware of their
signs and symptoms of syphilis vary depending in which of the four
stages it presents (primary, secondary, latent, and tertiary).
The primary stage classically presents with a single chancre (a
firm, painless, non-itchy skin ulceration), secondary syphilis with
a diffuse rash which frequently involves the palms of the hands
and soles of the feet, latent syphilis with little to no symptoms,
and tertiary syphilis with neurological, or cardiac symptoms.
is believed to have infected 12 million people worldwide in 1999,
with greater than 90 percent of cases in the developing world.
is easy to cure in its early stages. A single intramuscular injection
of penicillin, an antibiotic, will cure a person who has had syphilis
for less than a year. Additional doses are needed to treat someone
who has had syphilis for longer than a year. For people who are
allergic to penicillin, other antibiotics are available to treat
syphilis. There are no home remedies or over-the-counter drugs that
will cure syphilis. Treatment will kill the syphilis bacterium and
prevent further damage, but it will not repair damage already done.
It is difficult to be sure about the risk of HIV infection
in different parts of the world. However, it is clear that the infection
is widespread and although the risk is high amongst homosexual and
intravenous drug using groups, on a global scale, it is primarily
a heterosexually spread disease. Large numbers of the population
in many parts of Africa are infected and AIDS is common. Infection
is also widespread in other countries in Asia and South America.
High proportions of prostitutes are infected.
greatest increase in the number of HIV cases in the UK are heterosexually
acquired and about 75% of this figure can be attributed to sex with
a partner abroad.
immunodeficiency virus (HIV) is a member of the retrovirus family
that causes acquired immunodeficiency syndrome (AIDS), a condition
in humans in which progressive failure of the immune system allows
life-threatening opportunistic infections and cancers to thrive.
Infection with HIV occurs by the transfer of blood, semen, vaginal
fluid, pre-ejaculate, or breast milk.
Within these bodily fluids, HIV is present as both free virus particles
and virus within infected immune cells. The four major routes of
transmission are unsafe sex, contaminated needles, breast milk,
and transmission from an infected mother to her baby at birth. Screening
of blood products for HIV has largely eliminated transmission through
blood transfusions or infected blood products in the developed world.
From its discovery
in 1981 to 2006, AIDS killed more than 25 million people. HIV infects
about 0.6% of the world's population and in 2009 AIDS claimed an
estimated 1.8 million lives including approximately 260,000 children.
disproportionate number of AIDS deaths occur in Sub-Saharan Africa,
retarding economic growth and exacerbating the burden of poverty.
The only way to know whether you are infected is to be tested for
cannot rely on symptoms alone because many people who are infected
with HIV do not have symptoms for many years. Someone can look and
feel healthy but can still be infected. In fact, one quarter of
the HIV-infected persons in the United States do not know that they
Treatment with antiretroviral drugs reduces both the mortality and
the morbidity of HIV infection but antiretroviral medication is
still not universally available.
infects vital cells in the human immune system such as helper T
cells and when these cell numbers decline below a critical level,
cell-mediated immunity is lost, and the body becomes progressively
more susceptible to opportunistic infections.
people infected with HIV eventually develop AIDS. These individuals
mostly die from opportunistic infections or malignancies associated
with the progressive failure of the immune system. HIV progresses
to AIDS at a variable rate but most will progress to AIDS within
10 years of HIV infection.
anti-retrovirals increases the life expectancy of people infected
with HIV. Even after HIV has progressed to diagnosable AIDS, the
average survival time with antiretroviral therapy was estimated
to be more than 5 years. Without antiretroviral therapy, someone
who has AIDS typically dies within a year.
"Hepatitis means inflammation of the liver and also refers
to a group of viral infections that affect the liver . The most
common types are Hepatitis A, Hepatitis B, and Hepatitis C.
Viral hepatitis is the leading cause of liver cancer and the most
common reason for liver transplantation.
is a contagious liver disease that results from infection with the
Hepatitis A virus. It can range in severity from a mild illness
lasting a few weeks to a severe illness lasting several months.
Hepatitis A is usually spread when a person ingests fecal matter
even in microscopic amounts from contact with objects,
food, or drinks contaminated by the feces or stool of an infected
The best way to prevent Hepatitis A is by getting vaccinated.
is a contagious liver disease that results from infection with the
Hepatitis B virus. It can range in severity from a mild illness
lasting a few weeks to a serious, lifelong illness. Hepatitis B
is usually spread when blood, semen, or another body fluid from
a person infected with the Hepatitis B virus enters the body of
someone who is not infected.
can happen through sexual contact with an infected person or sharing
needles, syringes, or other drug-injection equipment. Hepatitis
B can also be passed from an infected mother to her baby at birth.
B can be either acute or chronic. Acute Hepatitis B virus infection
is a short-term illness that occurs within the first 6 months after
someone is exposed to the Hepatitis B virus. Acute infection can
but does not always lead to chronic infection. Chronic
Hepatitis B virus infection is a long-term illness that occurs when
the Hepatitis B virus remains in a persons body.
Chronic Hepatitis B is a serious disease that can result in long-term
health problems, and even death.
The best way to prevent Hepatitis B is by getting vaccinated.
is a contagious liver disease that results from infection with the
Hepatitis C virus. It can range in severity from a mild illness
lasting a few weeks to a serious, lifelong illness. Hepatitis C
is usually spread when blood from a person infected with the Hepatitis
C virus enters the body of someone who is not infected. Today, most
people become infected with the Hepatitis C virus by sharing needles
or other equipment to inject drugs. Before 1992, when widespread
screening of the blood supply began in the United States, Hepatitis
C was also commonly spread through blood transfusions and organ
C can be either acute or chronic. Acute
Hepatitis C virus infection is a short-term illness that occurs
within the first 6 months after someone is exposed to the Hepatitis
C virus. For most people, acute infection leads to chronic infection.
Chronic Hepatitis C is a serious disease than can result in long-term
health problems, or even death.
is no vaccine for Hepatitis C. The best way to prevent Hepatitis
C is by avoiding behaviors that can spread the disease, especially
injection drug use.
Drug-taking, apart from being
illegal, might put the traveller in contact with people who are
HIV positive and should be avoided. Needle sharing is very dangerous.
Sharing needles to inject drugs or steroids is another way that
HIV can be passed to other people. Sharing of needles for tattoos,
piercings, and body art can also lead to infection. Someone with
HIV who shares a needle also shares the virus, which lives in the
tiny amounts of blood attached to the needle. Sharing needles also
can pass hepatitis and other serious infections to another person.
Draconian Drug Laws
Asias governments impose the toughest drug laws on the
planet. You cant blame them the legendary Golden
Triangle, an area bordering Thailand, Laos and Myanmar,
is right in the heart of the region, and is a world hotspot
of narcotics production.
Many other countries impose harsh penalties for the posesssion
and/or trafficking of illegal drugs. Very long prison sentences
and even the death sentence have been handed out to travellers
carrying illicit substances; so don't be tempted!
In spite of such draconian measures, certain places are flush
with illegal drugs. However, you should still defer to local
laws if offered a chance to indulge your status as
a foreigner does not make you less likely to be punished for
drug use, quite the opposite!
Some general advice:
bring illegal drugs with you. Dont get conned into
carrying drugs for others, whether as personal favors or
for profit. The risks far outweigh the possibility of getting
away with it.
youre bringing prescription drugs with you, play it
safe and bring the prescription for these drugs.
alarming research study recently published discovered that
the "innocent" commercial tattoo may be the number
one distributor of hepatitis C.
found that commercially acquired tattoos accounted for more
than twice as many hepatitis C infections as injection-drug
use. This means it may have been the largest single cause
of this form of hepatitis and you are twice as likely to be
infected with hepatitis C from getting a tattoo from a tattoo
shop than shooting up drugs.
focussed on "sanitized" commercial tattoo parlours
and not so called back-street or prison tattoos.
consider hepatitis B can be transmitted with as little as
0.00004 ml of blood, and can live on blood contaminated surfaces,
such as needles, tattoo machines, tables, etc. for over two
months, the risk of hepatitis is very real indeed.
piercing and HIV / Aids infection
Australian health officials are urging travellers to avoid getting
tattoos in developing countries after it was reported a West Australian
man contracted HIV after getting etched in Bali.
think of having a tattoo done, first of all remember that it involves
your skin being pierced and forming an open sore, and that blood
will also be involved in this procedure.
body art and tattoos are very popular some safety measures must
be taken. Since piercing the skin, and blood and needles are involved
some warning lights should be going off, since working with open
"wounds" and blood opens the entire Pandora's box of Aids
and Hepatitis infection.
In saying this, the risk of HIV as well as hepatitis transmission
exists if ANY of the instruments are not properly sterilized and
disinfected. When having a tattoo, ask the person doing it what
type of safety precautions are taken to prevent the spread of blood
borne infections, such as HIV or hepatitis.
Unless you are absolutely certain that the equipment being used
is sterile, skin-damaging procedures such as ear piercing, tattooing
and acupuncture should be avoided.
Health standards in many developing countries are drastically different
to those in more developed nations, and this should be kept in mind
at all times.
C is spread by infected blood and infected needles, which is the
virus' connection with tattooing. Tattoos involve lots of needles
making lots of sticks in the skin. Each stick carries potential
for contamination -- and not just with hepatitis, but also HIV.
of a cheap tattoo might sound good for the wallet, but the risks
associated with it are just too high - it's just not worth it.
from the health risks, some tattoos from developing nations use
cheap inks, which can run and blotch after a short time - it's best
to avoid it all together, and wait until you get to a parlour that
offers certifiable health standards.
It is strongly recommended that people who have had tattoos whilst
travelling abroad get a Hepatitis check as soon as possible. Hepatitis
can lie unnoticed for many years while doing serious damage. The
sooner hepatitis is detected the better the chances for survival.
If you have a tattoo get checked.
pointers when selecting a tattoo artist or piercing operator
sterile sealed needles must ALWAYS be used.
must use new needles at all times and the tattoo artist
must be disposing of used needles in a responsible way
after autoclaving them.
needles come in sterile sealed packages and INSIST ON
SEEING THE SEALED STERILE PACKAGE before the body artist
starts creating your body art tattoo.
working area must be neat and clean and must be sterilized
after each customer to minimize the risk of any infection.
unused razors must be used when shaving hair from areas
to be tattooed.
new container of ink must be used for EACH CLIENT.
health board license must be clearly displayed (if applicable)
to attest that the premises and practice have passed health
check your local city ordinances to see what safety rules
apply in your area.
In many developing countries standards
of infection control may be inadequate to prevent the spread of
blood borne infections. Instruments may not be sterilised between
patients and re-use of medical supplies, including needles and syringes
Travel packs are available from chemists and travel clinics, containing
sterile equipment for use in an emergency. These kits should be
supplied with a certificate showing contents and the reason for
its purchase, useful for customs clearance.
Blood transfusion: In most of Western
Europe, North America, Japan and Australasia all donated blood is
now screened for HIV antibodies.
However, in many developing countries there may be only the
most basic blood transfusion services and much of the blood donated
is unscreened. The risks from blood transfusion in such circumstances
are high. Thus, points to consider are:
accidents are the commonest
reason for needing a blood transfusion so they should
be avoided where possible, e.g. driving carefully.
blood transfusion should only
be accepted when essential.
pregnancy or any medical condition
which may lead to heavy blood loss, should be taken into
account before travelling to destinations where good medical
facilities will not be available.
knowing your blood group in
advance may make it easier to find a blood donor in an
Hepatitis B is a serious illness
which is spread as described above. Symptoms include chronic fatigue,
loss of appetite, fever and jaundice. In a small percentage of individuals
the disease may cause permanent damage or liver cancer.
there is a vaccine available which gives good protection against
the disease. However, it can take up to six months to become effective.
Vaccination is recommended for
those travelling to areas of high prevalence who plan to remain
there for lengthy periods such as voluntary workers, who may be
at risk from medical or dental procedures carried out in those countries.
Short term travellers are not generally
at risk but may place themselves at risk by their sexual behaviour.
It is given as a course of three 1ml intra-muscular injections,
the second 28 days after the first and the third 6 months after