Yeah, your definition of “rare” and mine must differ. According to CDC sources, Seroprevalence of HCV in the U.S. is approximately 0.2% in children younger than 12 years and 0.4% in those between 12 and 19 years of age (CDC, unpublished data). This implies possibly 150,000 children in the U.S. are currently infected. (I think the number is overinflated, but just the thought of more than 0.001% of kids with this is scary!)
Meanwhile, In Cameroon, 14.5% of schoolchildren tested positive for Hep C.
I think we’re both arguing for the same point. But I do disagree with your assertion that it’s “rare”. Eosinophilic Fasciitis is rare. Hep C in kids is not, unfortunately.
There are many, many reasons for enforcing “Universal” precautions in blood contact safety. Most of these are entirely practical:
You never know your patient. Yes, they’re little girls, but they can still have hepatitis A through X, HIV, rare parasites, whatever. As well as the increasingly scary vCJD/mad cow disease. Could be from in utero infection, could be from burgers (above), could be from infected transfusions, could be from a childish “blood sisters” ritual, could be from an infected relative with a thing for small girls (sorry, but it happens).
You rarely know yourself. When was your last STD screen? Your lover’s? Has he/she been faithful? Do you have the right to risk someone else because you’re PRETTY SURE you’re disease-free?
Good habits are your friends. If you put on gloves, every single time, the one time it’s an emergency and you find out halfway through that the patient is HIV+, well, your gloves were already on.
You’re less likely to get sued.
Equally valid reasons, more psychological in nature:
Wearing gloves every time makes it impersonal. If you wear the gloves with the 7-year olds, then when it comes time to treat the 16-year old slut of the troup she won’t be offeded by them, and you don’t have to consider NOT wearing gloves to avoid a confrontation. This becomes more relevant in, say, NYC, where local high risk factors include sexuality and race. Are you going to wear gloves for blacks but not whites? Gays but not straights? Do you think you’ll get sued?
In the context of a young girl scout troup, I think that every piece of exposure kids get about what is “normal” counts. If they see that universal precautions are normal, even when almost certainly unneeded, that sort of message will still be with them years down the road when their teenage boyfriends are whining about having to wear condoms.
Etc… Okay, I think I’ll stop. I’m frothing.
mischievous
P.S. You can get nitrile gloves in “natural”, i.e. colorless corpse-white, but they normally come in bright colors so they can be easily distinguished from latex in places that have both (like my lab).
“Meanwhile, In Cameroon, 14.5% of schoolchildren tested positive for Hep C.”
This reminds me of the time a Belgian expert on HIV and STD, quoting a study, said that 5% of pregnant American women had gonorrhoea. I submit that a more realistic appraisal can be found in a review of the epidemiology of chronic hep C infection in subSaharan Africa by Madhava, Burgess, and Drucker and published in Lancet Infect Dis (2002 May;2(5):293-302). According to them, :“Sub-Saharan Africa is of great interest because it is reported to have the highest HCV prevalence rate (5.3%)…” “We estimate the overall prevalence of HCV in Sub-Saharan Africa is 3.0%. The central African region has the highest estimated prevalence of 6%.”
"Seroprevalence of HCV in the U.S. is approximately 0.2% in children younger than 12 years "
OK, so let’s say that the Brownie troop in question (7-9 year olds) has 15 girls and that the epidemiology of hep C is the same in the UK as in the U.S. (which it probably isn’t). So if hep C were distributed randomly among 7-9 year old girls (which it probably isn’t) then we could expect that roughly one out of every 33 Brownie troops might have 1 girl carrying hep C. I would call that rare. Diabetes is common.