Blood Borne Viruses (BBVs)

Blood-borne viruses (BBVs) are viruses that some people (children and adults) carry in their blood and which can be spread from one person to another. Those infected with a BBV may show little or no symptoms of serious disease, but other infected people may be severely ill.

Looked After Children are not routinely screened for blood borne viruses. Decisions about whether a child should be tested will be considered as part of their Initial Health Assessment and based on their likely exposure to BBVs and best interests. This can be reviewed at subsequent assessments should risk factors changes. Except in an emergency situation, testing can only take place with the informed consent of the child (if they have capacity) or their parents / carers / person with Parental Responsibility.

The most common blood borne viruses in the United Kingdom are:

• Hepatitis B;
• Hepatitis C;
• HIV.

As well as through blood, these viruses can also be found and transmitted through other bodily fluids including;

• Vaginal secretions;
• Semen; and
• Breast milk.

Other body fluids or materials such as urine, faeces, saliva, sputum, sweat, tears and vomit carry a minimal risk of BBV infection, unless they are contaminated with blood. However, the presence of blood is not always obvious so care should always be taken to avoid infection.

It is very unlikely that staff or children living in the home will become infected with a BBV through everyday social contact with someone else living or working in the home.

BBVs are mainly transmitted sexually or by direct exposure to infected blood or other body fluids which are contaminated with infected blood. Within Children’s Homes, direct exposure could occur as a result of accidental contamination by a sharp instrument, such as a needle or broken glass. Infected blood may also spread through contamination of open wounds, skin abrasions, skin damaged due to a condition such as eczema, or through splashes to the eyes, nose or mouth. Following simple infection control measures can reduce the risk of infections passing from one person to another. See Section 2, Universal Precautions / Safe Practice

A Hepatitis B vaccine is available, and may be appropriate for staff working in Children’s Homes which accommodate children who are placed in an emergency, or provide placements for Unaccompanied Asylum Seeking Children (this is because Hepatitis B infection is more common in sub-Saharan Africa, east and southeast Asia, parts of South America, southern parts of eastern and central Europe, the Middle East and the Indian subcontinent). The need for a member of staff to be immunised should be determined by a risk assessment. Vaccination should only be seen as a supplement to reinforce other infection control measures.

The following universal precautions are recommended as safe practice for all staff  as they will reduce the spread of diseases and infections. These are common-sense precautions that will protect against blood borne viruses and other infections that may be transmitted via blood and body fluids.

They should be incorporated as standard practice at all times.

• Always use good basic hygiene practices, such as hand washing;
• Wear disposable gloves when dealing with blood if there is a risk of mixing body fluids (e.g. cuts, abrasions and eczema) and covering cuts with waterproof dressing;
• Wash skin with soap and water following any contact with blood or body fluids;
• Do not share items which may be contaminated with blood (e.g. razors, toothbrushes). Offer a separate container for above items as universal practice;
• Carefully dispose of contaminated waste safely and correctly;
• Promptly clear up any spillages of blood or other body fluids (with diluted bleach and disposable tissues / paper towels);
• Wash soiled clothing in hot water and detergent in a hot wash cycle;
• Provide safe sex advice to young people (age appropriate);
• Provide advice to young people re the importance of going to a licensed established which uses sterile equipment for ear piercing, body piercing or tattooing.

Also see: Information Sharing Procedure.

Information about health and medical history is confidential to the person concerned. Such confidential information can only be shared in limited circumstances. There are many situations where those caring for a child do not need to be informed that the child has a BBV (e.g. school). However, it may be appropriate to share this information with key workers in the home so they can fully care for the child concerned. For example to be able to meet their needs fully, carers will need to know if a child in a long term placement is on medication or is immuno compromised and at greater risk of infection.

Before sharing information about a child’s BBV, the following should be taken into account:

1. Is the sharing in the best interests of the child?
2. What information needs to be disclosed and to whom?
3. Do those with Parental Responsibility or the child (subject to age and understanding) consent to this information being shared?
4. Are there risks to carers / staff if the information is not disclosed?
5. If so, what are those risks?
6. Will those who receive the information be able to maintain confidentiality?

If the person with Parental Responsibility or the child does not consent to the information being shared, legal advice should be sought. All decisions to share information should be recorded.