Epidemiology of

Bloodborne diseases

Dr. Muhammad Bilal Shah

MBBS,MPH
 INTRODUCTION

• Bloodborne diseases are caused by the

pathogens such as viruses, bacteria that
are carried in the blood and are able to be
transmitted from one person to others via
blood.
• There are some diseases which are not
directly transmitted by the blood but they
need a vector for transmission, which are
called vector-borne diseases such as..
 INTRODUCTION

• Most common bloodborne diseases are

• Hepatitis B
• Hepatitis C
• HIV infection.
 INTRODUCTION

• Blood poses the greatest threat to health

in a laboratory or clinical setting due
to needlestick injuries e.g., lack of
proper needle disposal techniques
and/or safety syringes.
• These risks are greatest among
healthcare workers, including: nurses,
surgeons, laboratory assistants, doctors,
phlebotomists, and laboratory
 INTRODUCTION

technicians. These roles often require the

use of syringes for blood draws or to
administer medications.
•Also it’s a great threat to the people if blood
transfusion, dental extraction or other
surgeries are not carried out in aseptic
conditions.
HEPATITIS B & C INFECTION

• Hepatitis B (formerly known as "serum"

hepatitis) is an acute systemic infection
with major pathology in the liver, caused
by hepatitis B virus (HBV) and transmitted
usually by the parenteral route.
 GLOBAL

• Hepatitis B is endemic throughout the

world.
• Its prevalence varies from country to
country and depends upon a complex mix
of behavioral, environmental and host
factors.
• In general, it is lowest in countries or areas
with high standards of living.
 GLOBAL

• The HBV infection is a global problem,

with 66 percent of all the world's
population living in areas where there are
high levels of infection.
• More than 2 billion people worldwide have
evidence of past or current HBV infection
and 350 million are chronic carriers of the
virus, which is harbored in the liver.
 GLOBAL

• It causes an estimated 780,000 deaths

from cirrhosis of liver and hepatocellular
carcinoma.
• The virus causes 60-80 per cent of all
primary liver cancer.
• Every year, 3 - 4 million people are
infected with the hepatitis C virus.
 GLOBAL

• About 130-150 million people are

chronically infected and are at risk of
developing liver cirrhosis and/or liver
cancer from Hepatitis C infection
• More than 500,000 people die from
hepatitis C - related liver diseases every
year.
 PAKISTAN

• In Pakistan, there are estimated 7-9 million

carriers of hepatitis B virus (HBV)
• The number varies in different population
groups
• Target populations are health workers,
blood donors, IV drug abusers etc.
• Almost 5% Pakistani people are suffering
from Hepatitis B infection.
 PAKISTAN

• Almost 10 million people are infected with

HCV
• The prevalence rate is 6.7 %, 5 %, 1.5 %,
and 1.1 % in Punjab, Sindh, Baluchistan
and KPK respectively
 AGENT FACTORS

1) AGENTS:
 Hepatitis B virus
 Double shelled DNA Virus.
 Having 3 morphological forms
 All forms can circulate in the blood
 Only one is infectious.
 Infectious form is Called Dane Particle
 For HCV it is Hepatitis C virus
 AGENT FACTORS

2) RESERVOIR OF INFECTION:
 Man is the only reservoir of infection
which can be spread either from carriers or
from cases.
 The persistent carrier state has been
defined as the presence of HBsAg or HCV-
antigen for more than 6 months.
 AGENT FACTORS

3) INFECTIVE MATERIAL:
Contaminated blood is the main source of
infection, although the virus has been found
in body secretions such as saliva, vaginal
secretions and semen of infected persons.
 HOST FACTORS

1) AGE:
 The outcomes of HBV and HCV
infections are age-dependent.
 Acute hepatitis B occurs in approximately
1 per cent of perinatal, 10 per cent of early
childhood (1-5 years of age), and 30 per
cent of late (> 5 years age) HBV
infections.
 HOST FACTORS

2) HIGH RISK GROUPS:

 In Surgeons it is 50 times greater than
that in the general population, and is more
than twice that of other physicians.
 Recipients of blood transfusions
Health care and laboratory personnel
Homosexuals
 HOST FACTORS

 Prostitutes
 IV drug abusers
 Infants of HBV carrier mothers
 Recipients of solid organ transplants
 Patients who are immunocompromised
 ENVIRONMENTAL FACTORS

• Personal Hygiene
• Vaccination of the population
• Sanitation
• Non- sterilized instruments
• Unsafe sex practices
• Needles and syringes
 MODES OF TRANSMISSION

• Parenteral route
• Perinatal transmission
• Sexual transmission
• Horizontal transmission
• Oral transmission
 HIV INFECTION / AIDS

• AIDS, the acquired immuno-deficiency

syndrome is a fatal illness caused by a
virus known as the human immuno-
deficiency virus (HIV) which breaks down
the body's immune system, leaving the
victim vulnerable to a host of life-
threatening opportunistic infections,
neurological disorders, or unusual
malignancies
 GLOBAL SCENARIO

• There were approximately 37.9 million people

across the globe with HIV/AIDS in 2018. Of
these, 36.2 million were adults and 1.7 million
were children.
• AIDS-related deaths have been reduced by
more than 55% since the peak in 2004. In 2018,
around 770,000 people died from AIDS-related
illnesses worldwide, compared to 1.2 million in
2010 and 1.7 million in 2004.
 GLOBAL SCENARIO

• Approximately 79% of people with HIV

globally knew their HIV status in 2018. The
remaining 21% (about 8.1 million people)
still need access to HIV testing services.
• In 2018, 23.3 million people with HIV
(62%) were accessing antiretroviral
therapy (ART) globally, an increase of 1.6
million since 2017 and up from 8 million in
2010
 PAKISTAN SCENARIO

In Pakistan in 2018:
•160 000 people were living with HIV.
•HIV prevalence—the percentage of people
living with HIV—among adults (15–49 years)
was 0.1%.
•22 000 people were newly infected with HIV.
•6400 people died from an AIDS-related
illness.
 AGENT FACTORS

1) AGENT:
 Human immunodeficiency virus (HIV)
 It is double stranded RNA virus
 Two types of virus, HIV-1 and hiv-2
 Virus is capable of destroying
lymphocytes, thus destroying the
immunity of human
 AGENT FACTORS

2) RESERVOIR:
 These are cases and carriers. Once a
person is infected, the virus remains in the
body life-long.
The risk of developing AIDS increases
with time. Since HIV infection can take years
to manifest itself, the symptomless carrier
can infect other people for years
 AGENT FACTORS

3)SOURCE OF INFECTION:
 The virus has been found in greatest
concentration in blood, semen and CSF.
Lower concentrations have been detected in
tears, saliva, breast milk, urine, and cervical
and vaginal secretions.
HIV has also been isolated in brain tissue,
lymph nodes, bone marrow cells and skin.
 HOST FACTORS

1)AGE:
Most cases have occurred among sexually
active persons aged 20-49 years.
This group represents the most productive
members of the society, and those
responsible for child-bearing.
 HOST FACTORS

2) SEX:
 In North America, Europe and Australia, about 51 per
cent of cases are homosexual or bisexual men.
In Africa, the picture is very, different; the sex ratio is
equal.
Certain sexual practices increase the risk of infection
more than others, e.g., multiple sexual partners, anal
intercourse, and male homosexuality.
Higher rate of HIV infection is found in prostitutes.
 HOST FACTORS

3) HIGH RISK GROUPS:

 Male homosexuals
 Bisexuals,
 Heterosexual partners
 Intravenous drug abusers
 Transfusion recipients of blood and blood
products
 MODES OF TRANSMISSION

• SEXUAL TRANSMISSION
• BLOOD CONTACT
• VERTICAL TRANSMISSION
THANK YOU