Which of the following diseases would not be transmitted by blood?

Appeared in: SGPGI Nursing Officer-2022

Explanation

Hepatitis E virus (HEV) is primarily transmitted through the fecal-oral route, mainly by consuming contaminated food or water.
Unlike the other viruses listed, blood-borne (percutaneous) transmission of HEV is not its primary mode of spread.
The epidemiology of HEV is similar to Hepatitis A, often causing large waterborne outbreaks in areas with poor sanitation.
While rare cases of blood-borne transmission can occur, it is not the characteristic mode of transmission for HEV.

Option A: Hepatitis B is incorrect because it is a classic example of a blood-borne pathogen.
Option B: Hepatitis C is incorrect because it is primarily transmitted through direct contact with infected blood.
Option C: HIV is incorrect because it is a well-known virus transmitted through blood and other specific body fluids.

Clinical Relevance

Nursing practice connection: Knowing Modes of transmission for viral hepatitis and HIV helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Understanding transmission routes is fundamental for nurses to implement appropriate infection control measures, such as Standard Precautions for blood-borne pathogens and Enteric Precautions for fecal-oral pathogens.
Accurate knowledge of transmission prevents nosocomial infections and allows for effective patient and community education on prevention strategies.
What if? If the patient were a pregnant woman in her third trimester, a Hepatitis E diagnosis would be a critical concern due to the high risk of fulminant hepatitis and mortality, requiring intensive monitoring and specialized care.

How to Approach the Question

First, analyze the question's core requirement: identify the disease that is NOT transmitted by blood. This is a negative-framing question, asking for the exception.
Recall the primary transmission routes for each of the listed viruses.
Evaluate Option A (Hepatitis B): Known to be blood-borne and sexually transmitted. Eliminate this option.
Evaluate Option B (Hepatitis C): Primarily known for transmission via blood, especially through IV drug use. Eliminate this option.
Evaluate Option C (HIV): A classic example of a blood-borne and sexually transmitted virus. Eliminate this option.
Evaluate Option D (Hepatitis E): Recall that this virus, similar to Hepatitis A, is transmitted via the fecal-oral route (contaminated food/water). This makes it the correct exception.

Concept Tested & Keywords

Concept Tested: Modes of transmission for viral hepatitis and HIV.
Stem keywords: diseases, transmitted by blood
Lead-in keywords: not
Negative lead-in flag: The question asks to identify the disease that is NOT transmitted by blood, requiring elimination of the blood-borne pathogens.

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E6 Medicine Davidson Principles Practice 24e p. 898-900

E6 Medicine Harrison 22e Part 2 pp. 559-561, 556-558

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