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HIV: Tips for Caregivers to Avoid Infection

Topic Overview

HIV is present in the blood, semen, and vaginal fluids of a person who is infected with HIV and is usually spread by:

  • Unprotected sex (vaginal, anal, or oral) with a person who is infected with HIV. Using condoms is the only way to prevent getting or spreading HIV during sexual contact. Other forms of birth control do not protect against HIV.
  • Using a needle or syringe that has previously been used by a person who is infected with HIV. Needles include those used for injecting drugs or steroids or those used for tattoos.

You cannot get HIV through everyday contact with air, food, water, insects, animals, dishes, or toilet seats.

The following preventive steps can eliminate your risk of getting HIV from someone you are caring for.

  • Wear disposable gloves if you may have contact with blood or body fluids from a person who is infected with HIV. Also, cover any cuts, sores, or breaks in your exposed skin. Wear rubber gloves when cleaning articles soiled with urine, feces, or vomit to avoid infection with other germs, even though HIV has never been spread by contact with these body products.
  • Wash your hands with soap and water after any contact with blood, even if you wear gloves.
  • Handle needles or lancets carefully to avoid sticking yourself if you are caring for someone who is injecting medicine or must test his or her own blood (for diabetes). Do not put caps back on needles by hand. When handling used syringes, pick them up by the barrel and carefully drop them into a puncture-proof container.
  • If you stick yourself with a used needle, wash the wound thoroughly with soap and water. Contact your doctor as soon as possible to get further evaluation and perhaps treatment with antiviral medications. The risk of developing an HIV infection is slight (about 1 in 300), but this risk can be greatly reduced if you get treatment right away, preferably within 1 to 2 hours.footnote 1

If you are a caregiver for a person who is infected with HIV:

  • Wash clothing and linens as you normally would. The clothes do not need to be separated from the rest of the household laundry.
  • Separate dishes or eating utensils are not needed. Dishes used by a person infected with HIV do not require special methods of cleaning.
  • Let the person infected with HIV prepare meals if he or she would like to. The virus cannot be spread through food handling.
  • Do not share razors or toothbrushes with anyone who has HIV because these items sometimes have blood on them.
  • Flush all liquid waste that contains blood down the toilet.
  • Place in a plastic bag all items that are soiled with blood, semen, or vaginal fluid and are not flushable, such as paper towels, sanitary pads and tampons, and wound dressings. Close the bag securely before placing it in a trash container. Check with your doctor or local health department to be sure you are following proper disposal regulations for your area.

A person who is infected with HIV can sometimes have other infections that may be contagious. The following steps can prevent the spread of other infections.

  • Gastroenteritis may cause diarrhea in a person who is infected with HIV. Wear gloves if you come in contact with the person’s feces, and wash your hands carefully with soap and water afterward. You should not prepare food for others if you have diarrhea.
  • Tuberculosis (TB) may be the cause of a cough that has been present for more than a week or two in someone who has HIV. Anyone who lives with or visits the home of a person who has TB should be checked by a doctor, even if no cough has developed.
  • Chickenpox can cause serious problems for a person who has HIV. Avoid contact with anyone you know who has chickenpox.
  • Herpes simplex can be spread by kissing or touching the fever blisters or cold sores around the mouth or nose of a person who has HIV.
  • Cytomegalovirus (CMV) may be present in urine and saliva of a person who has HIV. Wash your hands carefully after touching the person’s saliva or urine. Wear disposable gloves if you know you are going to come in contact with urine. This is particularly important if you are pregnant because a pregnant woman who becomes infected with CMV may give the virus to her baby.

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“Strep throat” is a sore throat that is caused by Group A Streptococcus bacteria. It’s the most common bacterial infection of the throat, and the words “Strep Throat” (or “strep”) come from the name of the bacteria.

How does someone get strep throat?

“Strep” bacteria are contagious, and they spread through airborne droplets.

You can get strep by:

  • Breathing in the airborne droplets when someone who has it breaths, coughs, or sneezes near you
  • Sharing food/drinks, shaking hands with, or kissing someone who has strep
  • You can also pick up the bacteria by touching an object (such as a doorknob) after it has been contaminated by someone who has strep and then touching your mouth or nose

What are the symptoms of strep throat?

The most common symptoms of strep throat include:

  • Sore throat
  • Fever of 100.4°F or 38°C or higher
  • Trouble swallowing
  • Swollen, red tonsils (the tonsils may also have white patches)
  • Swollen glands (lymph nodes in your neck)
  • Fever
  • Headache
  • Fatigue (feeling very tired)

Less common symptoms include: skin rash, body aches, not feeling hungry, stomach ache, and throwing up. Having a runny nose or cold symptoms makes it unlikely you have strep throat.

If you have any of these symptoms or you’ve been close to someone with strep throat, it’s important to see your health care provider so he/she can test to see if you have strep. Some of the symptoms of strep throat are similar to those of another type of sore throat caused by viruses. However, a Group A strep infection is more serious and requires a visit to your health care provider, a rapid strep test and/or throat culture, and antibiotics.

How can my health care provider (HCP) tell if I have strep throat?

First, your HCP will look for signs and symptoms of strep throat, sore throat, swollen glands, and no runny nose or cold symptoms. He/she will likely ask you to open your mouth as wide as you can (and say “ahh”), then use a tongue depressor (an instrument that looks like a popsicle stick and is used to push your tongue down) to get a good look at your throat and your tonsils. Your HCP will feel your neck to check for swollen lymph nodes and may take your temperature to see if you have a fever.

Throat culture – Your HCP will also gently rub a sterile cotton swab over the back of your throat and tonsils. This doesn’t take long and isn’t painful, but it may cause you to gag for a second. The purpose of the swab is to get a sample that will be tested for strep bacteria.

After swabbing your throat, your HCP will do a rapid strep test. This test can detect strep bacteria within minutes. If the test is positive, your HCP will prescribe treatment right away. If the test is negative, a sample will be sent to a lab for more testing, because rapid strep tests may miss some strep infections.

What is the treatment for strep throat?

If you’ve tested positive for strep throat, your HCP will give you a prescription for antibiotics (usually penicillin, unless you’re allergic). The medicine will help lessen your symptoms and lower the chance of any complications. You can return to school and work after you have been on the medicine for 24 hours.

Even though you will start feeling better within a day or two of starting the antibiotics, it’s extremely important that you take ALL of the medicine your HCP prescribed for you. If you stop taking the medicine early, the strep could come back.

Other things you can do to feel better when you have strep throat include:

  • Drink lots of fluids – cool liquids such as water and ginger ale can help. Sucking on an ice pop and drinking warm liquid such as soup and decaffeinated tea are good too.
  • Rest – take naps and go to bed early
  • Gargle with salt-water but don’t swallow
  • Try throat lozenges
  • Take acetaminophen or ibuprofen. Ask your health care provider how much you should take.

Is there anything I can do to prevent getting strep throat?

Yes. Avoid being around anyone who has strep. If you’re living with someone who has a strep infection, wash your hands often, and don’t share drinking glasses, eating utensils, or toothbrushes.

It’s also important to prevent re-infecting yourself. If you have strep, make sure to get a new toothbrush. Buy a new toothbrush (throw the old one away) when you have been on antibiotics for 2-3 days to lower your chance of getting re-infected. Otherwise it’s possible for the bacteria to live in the toothbrush and make you sick again once you’ve finished your medicine.

If you’re concerned about strep throat, here’s a tip on how to bring it up with your health care provider: “I have a sore throat.”

It’s tough to determine whether or not you have strep throat because it may share symptoms with other conditions. The best way to confirm your suspicions is by visiting your doctor or a healthcare professional, who will likely examine your throat and lymph nodes. They’ll want to know more about your symptoms and history with strep throat. Your healthcare provider may also take a swab from the back of your throat for further analysis.

There are two common tests used to diagnose strep throat – a rapid antigen test and a throat culture. The first one is just that – a rapid, fast test that’ll have results in minutes after swabbing the back of your throat. Aka, you’re back on the couch watching re-runs of your favorite show faster. As for the throat culture, it may take several days for results to come back. Similar to the other test, though, a swab is taken from the back of your throat and tonsils.

So what happens when you are diagnosed with strep? The good news is that since strep throat is a bacterial infection there are antibiotics, like penicillin or amoxicillin that your doctor can prescribe to get you on the mend. Medicine can help lessen both the duration of your illness and contagious period as well as help to prevent some complications of strep, most notably rheumatic heart disease. If you’re considering making any plans, keep in mind that you should avoid contact with anyone for at least 24 hours after you start taking the antibiotics. Strep throat can be highly contagious, and that 24-hour period will help protect you and others from the unpleasant illness.

While you wait to feel better, there are measures you can take at home to get you or your child back to your normal, healthy selves. Consider these tips the next time you or a loved one has strep throat, though you should consult with your primary care physician before using these in small children:

  • Cool liquids can help soothe the throat and keep you hydrated
  • Warm liquids help soothe an inflamed throat and tonsils
  • Throat lozenges or throat sprays may also numb or soothe your throat
  • Gargling warm salt water can help soothe throat soreness

What Our Doc Says:

“Even if you’re not running a fever, Tylenol and ibuprofen can help with throat pain and over-the-counter lozenges or sprays can also provide relief. It’s also important to remember that dehydration makes a sore throat even more painful. Some prefer warm drinks, some prefer cold drinks, but even though it hurts to swallow, you need to stay hydrated until the antibiotics kick in.”

-Nancie Fitch, DO, Area Medical Director, MedExpress

Bronchitis

Speaking of unpleasant illnesses, bronchitis is another common winter ailment that can affect your throats nearby neighbor, the bronchial tubes. Curious about what exactly your bronchial tubes are? They’re the passages that carry air from the trachea (windpipe) into the lungs and need to be kept clear and healthy for proper breathing. When the lining of the bronchial tubes gets inflamed, a thick mucus is produced, which irritates the lungs and breathing process.

There are two types of bronchitis: chronic and acute. Acute bronchitis is more common, so common that you may have heard it called by another name before – a chest cold.3 Why? Because it’s an infection in your chest that lasts anywhere from a week to 10 days and has some cold-like symptoms, including:

  • Cough
  • Production of mucus when coughing
  • Fatigue
  • Shortness of breath
  • Slight fever and chills
  • Sore chest

Where exactly does bronchitis come from? Similar to the flu and colds, acute bronchitis is usually caused by viruses. It typically follows the onset of a cold or another respiratory infection. But wait, how can you prevent acute bronchitis? Again, it’s recommended to practice healthy hygiene habits. Washing your hands and using hand sanitizer can go a long way in reducing your risk of catching these nasty viral infections.

Though it’s not always winter-related, there’s also chronic bronchitis to consider. Chronic bronchitis is associated with coughs that lasts several months, with recurring bouts or flair-ups every few years. While it is generally associated with smoking, that’s not always the case. It can also be brought on through dust, toxins, and air pollution. If you’re exposed to fumes, dust, or smoke for extended periods of time, it might not be a bad idea to wear a surgical mask to help prevent inhaling these irritants.

Healthcare providers can help diagnose bronchitis by learning more about your symptoms and medical history. In some cases, they may also order blood work to help spot infections, or an X-ray to help identify any issues in your lungs and bronchial tubes.

Similar to many other illnesses, the treatment plan for bronchitis includes rest and hydration.

Unfortunately, antibiotics won’t help kick it to the curb, since bronchitis is typically a viral infection. Instead, you can take ibuprofen or acetaminophen to help manage any discomfort until the illness has run its course. Sometimes, your doctor may prescribe a bronchodilator to open up your airways. And while you’re sick, it’s a good idea to avoid secondhand smoke or other fumes. You can also try:

  • Taking over-the-counter cough suppressants
  • Consuming a couple teaspoons of honey to help soothe an irritated throat
  • Using a humidifier, which will help loosen and break up mucus

It’s always a good idea to discuss treatment, including over-the-counter medications, with your healthcare provider.

What Our Doc Says:

“Bronchitis is usually viral and best treated with symptomatic medications. Some swear by multi-symptom products, but sometimes you get medications mixed in there for symptoms that you don’t have. Your doctor may consider treating each symptom individually. Drink lots of fluids and get lots of rest. If you start running a fever, or wheezing, it’s best to get evaluated.”

-Nancie Fitch, DO, Area Medical Director, MedExpress

Until spring weather breaks, you’re likely going to encounter a number of winter illnesses and conditions. Hopefully next time you’ll better understand what’s plaguing you and what can be done about it. And if a winter worry does strike, MedExpress is here to help you get back to your best you.

Super Gonorrhea Is Spreading: What’s Oral Sex Got To Do With It

You never want to see the words “gonorrhea” and “super” in the same sentence, such as “super, you have gonorrhea” or “gonorrhea is super.” However, “super” gonorrhea is becoming an increasing reality around the world.

Super gonorrhea is not the next DC Comics television show or movie, like Superman or Supergirl. It is a sexually transmitted bacteria, Neisseria gonorrhoeae, that is resistant to most if not all the antibiotics that we have available. A slang term for gonorrhea is “the clap”…but no one is clapping about the around 78 million new gonorrhea infections that occur each year. As a just-released World Health Organization (WHO) report explains, “data from 77 countries show that antibiotic resistance is making gonorrhea–a common sexually transmitted infection–much harder, and sometimes impossible, to treat.” In fact the WHO has indicated that strains of untreatable gonorrhea have emerged in three countries: Japan, France and Spain. Just super.

Why is antibiotic-resistant gonorrhea spreading? One problem is unprotected oral sex. Remember, unprotected oral sex is not “safe sex.” (You know the joke that the only safe unprotected sex is when you are in different zip codes.) Oral sex can transmit Neisseria gonorrhoeae from someone’s privates to your throat and vice versa. And up to 90% of people with oral gonorrhea have no or minimal symptoms. Yes, many people do not even realize that they have oral gonorrhea. Think about that next time you want a good conversation starter at a cocktail party.

Even if you do develop symptoms, the symptoms can be hard to distinguish from typical symptoms of other types of throat infections such as strep throat (another name for streptococcal pharyngitis): sore throat, difficulty swallowing and redness of the throat. Symptoms typically emerge one to three weeks after the initial infection. Then, if your doctor doesn’t test you for strep throat when you actually have “gonorrhea throat” and instead automatically gives you antibiotics, the antibiotics can then select for antibiotic-resistant gonorrhea. You can then pass antibiotic-resistant gonorrhea to someone else’s privates through oral sex. This is the circle of life for super gonorrhea.

Your doctor can diagnose oral gonorrhea via a throat swab or culture. Standard treatment for gonorrhea is a shot (intramuscular injection, not a drink) of ceftriaxone and oral azithromycin. However, the emergence of super gonorrhea is decreasing and potentially eliminating treatment options. Oh, and gargling with salt water or mouthwash is not a treatment for oral gonorrhea:

Without effective treatment, your body may be able to naturally clear gonorrhea from your body in weeks to months. However, this does not always occur, and untreated gonorrhea has the potential to wreak all kinds of havoc. If you are a woman, untreated gonorrhea can lead to pelvic inflammatory disease (PID), which can in turn lead to things such as pelvic or abdominal pain, ectopic pregnancies (when the fetus grows outside the uterus), pregnancy complications and infertility. If you are a man, untreated gonorrhea can cause bad inflammation and pain in your testicles. If you are a man, that last sentence may have gotten your attention. Once you recover from that sentence, keep in mind that such inflammation can also lead to infertility or sterility. Untreated, the bacteria can also spread to other parts of your body and even be life threatening.

Super gonorrhea is scary, more scary than this “zombie fish,” regardless of what Aimee Lutkin for Jezebel and her poll may say:

魚の生命力が凄い pic.twitter.com/LjoIO3609n

— 鈴木豊 Yutaka Suzuki (@Q57OUPrpy8OZaWt) July 5, 2017

What can you do to protect against super gonorrhea? Dispel the notion that oral sex is automatically safe sex. Unless you are sure that your partner does not have gonorrhea, use condoms or dental dams for protection. Of course, condoms or dental dams are not 100% effective but they are much better than using nothing. Moreover, don’t automatically treat sore throats with antibiotics, and be clear to your doctor about your sexual history. You and your partner also should make sure you are tested and be upfront with each other about sore throats or any other symptoms.

While super gonorrhea won’t be a character on the next Justice League movie, unless something changes, you probably will be seeing more and more of it in the coming years. The WHO also expressed concern that only three new possible antibiotics are under clinical development for gonorrhea: solithromycin (which has recently completed a phase III clinical trial), zoliflodacin (phase II) and gepotidacin (phase II). Since many drugs under development never actually make it to market, without more being done to stimulate antibiotic research and development, the future of gonorrhea looks super…for gonorrhea, that is.

Strep throat is treated with antibiotics. Antibiotics kill bacteria. Killing bacteria helps ease the symptoms of strep throat and helps it go away a little faster. Antibiotics can also prevent a few rare, but serious conditions that people who have strep throat might develop. These include rheumatic fever or kidney inflammation.

It is important to take all of the antibiotics your doctor prescribes. This reduces the risk that your symptoms will return. It also helps prevent antibiotic resistance.

Should all sore throats be treated with antibiotics?

No. Not every sore throat is strep throat. Bacteria only cause a small portion of all sore throats. The rest are caused by viruses or other problems that antibiotics do not help. Your doctor can do a test to check for strep throat.

What can make my sore throat feel better?

Here are some things that might help you feel better:

  • Take ibuprofen (some brand names: Advil, Motrin) or acetaminophen (one brand name: Tylenol) to relieve pain and reduce fever. Children should not take aspirin. Aspirin can cause a serious illness called Reye’s syndrome when it is given to children younger than 18 years of age.
  • Gargle with warm salt water (1/4 teaspoon of salt in 1 cup of warm water).
  • Adults and older children can suck on throat lozenges, hard candy, pieces of ice, or popsicles.
  • Eat soft foods (such as yogurt and applesauce) and drink cool drinks or warm liquids (such as broths, soups, and tea).
  • Get plenty of rest. Sleep helps your body fight infection.
  • Drink plenty of water. This helps keep your throat lubricated and helps prevent dehydration.
  • Avoid acidic or spicy foods and drinks (such as orange juice and peppers).

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