Blood Borne Viruses

Blood-borne viruses (BBVs) are viruses that some people 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 young person 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 change. Except in an emergency situation, testing can only take place with the informed consent of the young person (if they have capacity) or as a best interest decision by a health professional if the young person does not have capacity. Please see Mental Capacity Act.

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 young people will become infected with a BBV through everyday social contact with someone else living or working in the Service.

BBVs are mainly transmitted sexually or by direct exposure to infected blood or other body fluids which are contaminated with infected blood. 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 the Service which accommodate young people who are placed in an emergency, or provide placements for Unaccompanied Asylum Seeking young people (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 and young people who live in a group living setting where there is a risk of a BBV 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). Use a separate container for above items in bathrooms;
• 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 regarding the importance of going to a licensed establishment which uses sterile equipment for ear piercing or body piercing.

Also see: Information Sharing Procedure. 

Information about health and medical history is confidential to the young person concerned. Such confidential information can only be shared in limited circumstances. There are many situations where those caring for a young person do not need to be informed that the young person has a BBV (e.g. college). However, it may be appropriate to share this information with key workers in the Service so they can fully support the young person concerned to avoid infections of others.

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

1. Is the young person happy for this information to be shared and with whom?
2. Is the sharing in the best interests of the young person if the young person does not have capacity?
3. What information needs to be disclosed and to whom?
4. Are there risks to 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 young person does not consent to the information being shared, further advice may need to be sought to keep both other young people and staff safe. All decisions to share information should be recorded.

Legislation, Statutory Guidance and Government Non-Statutory Guidance

Health and Safety Executive (HSE) – Blood Borne Viruses