I apologize if I sound ignorant posting here. 4 weeks ago I was working with a patient who had hip surgery. Serous fluid from her wound got on my pants which soaked to my leg during a difficult transfer back to bed. I forgot to wash my leg because it dried so quickly and later that day I went to the gynecologist. The gynocologist might have briefly contacted the area of serous fluid dried on my leg and then did an external vulvar exam.
I am vaccinated once in childhood and once in 2021 and so did not worry. But then I found my titers to be 3.5 on a very recent test and so was not able to act with good sense and get PEP.
I struggle with OCD and am having a hard time getting out of bed over this situation. I am wondering if anyone who researches Hep B and has knowledge can guide me.
I see my doctor Wednesday but I’m just terrified.
Hi @Bobmom087,
Welcome to the community, and I am sorry to hear about your ordeal. You will definitely need a booster to help raise your antibodies back up to protective levels. Antibodies wane overtime which seems to be the case here.
Did you report this incident to your health and safety department/officer? If not, I will recommend that you do so as soon as possible.
I will say, try to calm down. I will be worried too, but we don’t have any evidence that this person has hepatitis B. Don’t beat yourself up, and let’s remain hopeful that there is nothing to this incident.
Keep us posted on how things go with your visit next week. Bansah1
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I’d agree with @Bansah1 here. There’s no evidence that the other person has hep B and even if they did, if there was no break in your skin, then it is unlikely that there has been any exposure.
Thomas
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@thomastu Would the indirect contact with the serous fluid and the exam at the gynocologist be considered a mucuous membrane exposure? I was dealing with a yeast infection that was mostly healed after a round of steroid/antifungal cream and I’m worried that made my vulva susceptible to the virus. Im sorry if that sounds crazy. The skin on my leg was intact
My visit with the doctor didn’t go well, she gasped outside the door when the medical assistant told her what I had shared and I called off work the next day I was so traumatized. She insisted I get tested for HIV and Hep B but also didn’t seem to know a whole lot about testing windows and so on.
Hi @Bobmom087,
So sorry to hear about your experiences and stress around it. There are several factors that mean this is low risk:
- There is no evidence that this other person has Hep B
- As far as I know, secondary contact (leg to hand, hand to mucus membrane) generally conveys a lower risk of transmission compared to primary contact.
- If the fluid had dried, transmission is even less likely.
- You had mentioned that this was an external vulvar exam, which doesn’t sound like contact with mucosal membranes.
- As mentioned, antibodies wane over time, but upon exposure the memory B cells get activated and perform protective functions.
I hope these factors will help you settle your nerves.
TT
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Hi @Bobmom087,
I agree with Thomas on this. The risk would be low, since you don’t know that the person had hep B, and you had the vaccine in the past. If you are working in healthcare, I would probably recommend getting a booster to get your antibody levels back up, but usually immune memory gets activated if you are exposed to the virus.
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Recieved negative results for HbsAg and Hep B core antibody total at 8 weeks post exposure. Waiting to see if my booster shows recognition of the vaccine and go from there.
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Hey Thomas,
I just received results back from my “Challenge” booster and my surface antibodies came up to 209 mlU/mL from my previous test of 3.5mlU/mL. Does this mean my body maintained immune memory and I was likely protected during the exposure I had?
I am wondering if I should still test for hep b surface antigen at 12 weeks.
Thank you for your help and encouragement.
Hi @Bobmom087,
Your results are great and suggest that you were not exposed or infected. It is probable that your immunological memory was sufficient to protect you against any potential exposure. If you need the peace of mind, it might be worth considering the HBsAg test.
Thomas