Needle stick injury can result in all of the following; EXCEPT:

AIIMS Delhi NO- 2019

Applied Microbiology & Infection control

Medium

Appeared in: AIIMS Delhi NO- 2019

Explanation

Malaria is caused by the Plasmodium parasite, which is primarily transmitted by the bite of an infected Anopheles mosquito.
While the parasite is present in the blood of an infected person, transmission through a needlestick injury is extremely rare and not considered a primary occupational risk.
Standard post-exposure protocols for needlestick injuries in healthcare settings focus on viruses like HIV, HBV, and HCV, and do not routinely include testing or prophylaxis for Malaria.

Option A: HIV is a well-known bloodborne virus that can be transmitted through a needlestick injury. The risk of seroconversion after a single percutaneous exposure is approximately 0.23%.
Option B: HBV is the most infectious bloodborne virus transmitted via needlestick. The risk of transmission from a single injury can be as high as 6-30% in an unvaccinated individual.
Option C: HCV is another significant bloodborne virus. The risk of transmission from a needlestick is approximately 1.8%, which is higher than that of HIV.

Clinical Relevance

Nursing practice connection: Knowing Transmission of bloodborne pathogens via needlestick injury helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Adherence to universal precautions and the Needlestick Safety and Prevention Act (e.g., using safety-engineered devices, proper sharps disposal) is paramount in preventing occupational exposures.
Nurses must understand the critical, time-sensitive nature of reporting an exposure. Delaying the initiation of Post-Exposure Prophylaxis (PEP) can significantly reduce its effectiveness.
What if? If the exposed nurse is not vaccinated against Hepatitis B, the risk of infection increases dramatically (up to 30%). Immediate post-exposure prophylaxis with Hepatitis B immune globulin (HBIG) and the initiation of the HBV vaccine series is critical to prevent infection.

How to Approach the Question

First, identify the keyword 'EXCEPT' in the question stem. This indicates you are looking for the option that does not fit the given condition.
The condition is 'result in' from a 'Needle stick injury'. This means you need to find the disease that is NOT typically transmitted this way.
Recall the common bloodborne pathogens that are an occupational hazard for healthcare workers. HIV, HBV, and HCV are the three most well-known viruses transmitted through blood.
This immediately makes options A, B, and C likely distractors (i.e., they ARE transmitted by needlesticks).
Evaluate the remaining option, Malaria. While it is a disease involving the blood, recall its primary mode of transmission. Malaria is primarily vector-borne (mosquitoes).
Conclude that because its primary transmission route is different and the risk from a needlestick is negligible compared to the others, Malaria is the correct exception.

Concept Tested & Keywords

Concept Tested: Transmission of bloodborne pathogens via needlestick injury
Stem keywords: Needle stick injury, result in, transmission
Lead-in keywords: EXCEPT
Negative lead-in flag: The question asks for the exception among the given options.

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E6 Medicine Harrison 22e Part 1 p. 1605-1607

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