1988 Agent Summary Statement for Human Immunodeficiency Virus and Report on Laboratory-Acquired Infection with Human Immunodeficiency Virus [MMWR, Vol 37 No.S-4]

Vol. 37 / No. S-4

MMWR

concluded that the most plausible source of exposure was contact of the worker's
gloved hand with virus-culture supernatant, followed by inapparent exposure to skin.
In October 1987, a second person who worked in another HIV production facility
was reported to have HIV infection (18). This laboratory was a well-equipped BSL 3
facility, and BSL 3 practices were being followed. This worker reported having
sustained a puncture wound to a finger while cleaning equipment used to concentrate
HIV.
Laboratory Hazards
HIV has been isolated from blood, semen, saliva, tears, urine, cerebrospinal fluid,
amniotic fluid, breast milk, cervical secretions, and tissue of infected persons and
experimentally infected nonhuman primates. In the laboratory, virus should be
presumed to be present in all HIV cultures, in all materials derived from HIV cultures,
and in/on all equipment and devices coming into direct contact with any of these
materials.
In the laboratory, the skin (especially when scratches, cuts, abrasions, dermatitis,
or other lesions are present) and mucous membranes of the eye, nose, mouth, and
possibly the respiratory tract should be considered as potential pathways for entry of
virus. Needles, sharp instruments, broken glass, and other sharp objects must be
carefully handled and properly discarded. Care must be taken to avoid spilling and
splashing infected cell-culture liquid and other virus-containing materials.
Recommended Precautions
1. BSL 2 standards and special practices, containment equipment, and facilities, as
described in the CDC-NIH publication Biosafety in Microbiological and Biomedical
Laboratories (Guidelines), are recommended for activities involving all clinical
specimens, body fluids, and tissues from humans or from infected or inoculated
laboratory animals. These are the same standards and practices recommended
for handling all clinical specimens. For example, and for emphasis:
a. Use of syringes, needles, and other sharp instruments should be avoided if
possible. Used needles and disposable cutting instruments should be discarded into a puncture-resistant container with a lid. Needles should not be
re-sheathed, bent, broken, removed from disposable syringes, or otherwise
manipulated by hand.
b. Protective gloves should be worn by all personnel engaged in activities that
may involve direct contact of skin with potentially infectious specimens,
cultures, or tissues. Gloves should be carefully removed and changed when
they are visibly contaminated. Personnel who have dermatitis or other lesions
on the hands and who may have indirect contact with potentially infectious
material should also wear protective gloves. Hand washing with soap and
water immediately after infectious materials are handled and after work is
completed-EVEN WHEN GLOVES HAVE BEEN WORN as described aboveshould be a routine practice.
c. Generation of aerosols, droplets, splashes, and spills should be avoided. A
biological safety cabinet should be used for all procedures that might generate
aerosols or droplets and for all infected cell-culture manipulations. The
Guidelines (pp. 11-13) contain additional precautions for operating at BSL 2.