Question: We have a patient that may benefit from aquatic therapy - however, the patient is positive for Hepatitis C - would this be a concern for aquatic therapy?
Answer: Hepatitis C (and B) is spread primarily by blood-to-blood contact, like occurs with transfusions, needle sticks, and IV drug use. The CDC is not aware of any instances in which a person has become infected with these germs after being exposed to a blood spill in a pool (see their statement below). Hep B and C are not fecal borne, like Hepatitis A.
Even if an infected patient had a cut or other method of blood spill, properly treated pool water will kill the pathogens almost immediately. The way that I read it, the CDC feels that blood spills are not even a reason for the pool to shut down, the likelihood of any blood borne pathogen to transmit is so infinitesimal. That said, you should always follow your facility infection control policies and any existing guidelines from your local or state regulatory agencies if they conflict with this information!
Here is the CDC's policy:
Blood Contamination of Pool Water
Check for existing guidelines from your local or state regulatory agency before use. Healthy Swimming recommendations do not replace existing state or local regulations or guidelines.
The most common germs spread through recreational water are ones that cause diarrheal illnesses and skin rashes. These germs are spread by swallowing or by skin exposure to water that has been contaminated with germs. Coming into contact with vomit and/or blood in pool water is unlikely to spread illness.
Blood in Pool Water
Germs found in blood (for example, Hepatitis B virus or HIV) are spread when infected blood or certain body fluids get into the body and bloodstream (for example, by sharing needles or by sexual contact). Chlorine kills germs found in blood and CDC is not aware of any instances in which a person has become infected with these germs after being exposed to a blood spill in a pool.
- Does chlorine kill the germs in blood?
- Yes. These germs do not survive long when diluted into properly chlorinated pool water.
- Swimmers want something to be done after a blood spill. Should the pool be closed for a short period of time?
- There is no public health reason to recommend closing the pool after a blood spill. However, some pool staff choose to do so temporarily to satisfy patrons.