Do Feces Transmit HIV? CDC MMWR Weekly Writes it Might, Here’s the Proof

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It didn’t take long (17 minutes, in fact) for someone to incorrectly declare that you can’t get HIV from feces — referring to an article posted on The Cardinal at 12:20 p.m. about feces smeared in an underground parking garage.

The Cardinal wrote: “Feces is a biohazard. Biohazard waste is sometimes referred to as medical waste, biomedical waste, or infectious waste. Biohazard waste includes bodily fluids and matter such as urine, blood, vomit, feces, and other tissues.

Improper or inadvertent contact with feces constitutes the risk of exposure to HIV, organisms responsible for viral hepatitis, and organisms responsible for GI infections, such as gastroenteritis (stomach flu), infectious diarrhea, amebiasis, and more.”

Alissa writes: “well you cannot get HIV from sh*t so that info is false.”

HIV in feces

Way back to 1994, the Centers for Disease Control and Prevention (CDC) published a report titled “Human Immunodeficiency Virus Transmission in Household Settings — United States”

One of the subjects of the report was a 75-year-old woman, who tested positive for HIV antibody after taking care of her son, who died of aids in August 1990.

The CDC editorial notes report that the 75-year-old woman most likely became infected while providing nursing care for her son. The CDC report in MMWR Weekly published that, “although the precise mode of transmission is unknown, she had direct contact with her son’s urine and feces; because of his chronic gastritis and duodenitis, some blood could have been present in his feces, even though the blood was inapparent to his mother. In addition, she could have had other unrecognized or unrecalled exposures to her son’s blood.”

While someone might argue that feces alone might not carry HIV, feces can carry blood, and blood can transmit HIV. Additionally, AIDS.gov, the internet portal for all Federal domestic HIV and AIDS resources and information, advises that AIDS can also be transmitted from “Rectal fluids” — which, of course, may also be mixed with feces.

To say that feces absolutely cannot transmit HIV is a highly misleading statement. To say, as Alissa does, that a statement that says “feces can transmit HIV is false info” (re: “contact with feces constitutes the risk of exposure to HIV”) is actually untrue and unverifiable.

On the main page on HIV AIDS BASICS regarding the basics of HIV transmission, AIDS.gov does NOT commit to say that feces cannot tranmit HIV.

AIDS.gov does say,

HIV IS NOT SPREAD BY…

HIV does not survive long outside the human body (such as on surfaces) and it cannot reproduce outside a human host. It is not spread by:

Air or water

Mosquitoes, ticks or other insects

Saliva, tears, or sweat that is not mixed with the blood of an HIV-positive person

Shaking hands, hugging, sharing toilets, sharing dishes/drinking glasses, or closed-mouth or “social” kissing with someone who is HIV-positive

Drinking fountains

Other sexual activities that don’t involve the exchange of body fluids (for example, touching).

Strangely, the U.S. Department of Veterans Affairs conflicts with the AIDS.gov website and advises that HIV is NOT spread through feces. However, it provides no sources that verify this to be true and provides no scientific proof.

There are no health professionals that would voluntarily contact feces without personal protection, especially gloves.

While the risk of fecal transmission of HIV is unlikely and not reported frequently, there is no reason to deny the possibility, or be careless in practice while believing that fecal transmission is impossible.

Below is the CDC MMWR Weekly Report without the editorial note (for the full report with Editorial Note see MMWR Weekly May 20, 1994 / 43(19);347,353-356)

+ + + + +

In August 1991, a 75-year-old woman was evaluated because of fatigue and malaise and tested positive for HIV antibody; her adult son died in August 1990 as the result of AIDS. Her CD4+ T-lymphocyte count was 837 cells/uL. She had been married for approximately 50 years; her husband tested negative for HIV antibody. The patient reported no other sex partners and denied all risk factors for HIV infection, including injecting-drug use and receipt of blood or blood products since 1978; she had not been employed in a health-care setting. The woman had a cholecystectomy in December 1990; in February 1992, all members of the surgical team tested negative for HIV antibody.

Her son had lived in the household from September 1989 until his death. He initially was able to care for himself; however, in July 1990 (6 weeks before his death), his mother began to provide daily nursing care for him (e.g., bathing, feeding, changing diapers, and repositioning his urinary catheter). Although she had been informed of the need to wear gloves while providing such care, she reported inconsistent adherence to this recommendation. She could not recall any direct exposures to her son’s blood. Her son did not require intravenous fluids or medication in the home nor did he have an intravascular device. No needles or other sharp instruments related to his care were in the home. Dermatologic conditions had not been noted.

The son had hemorrhoids and diarrhea, but neither visible blood nor melena had been noticed at home. The mother reported skin contact with her son’s feces on at least one occasion. While hospitalized in February 1990, he had upper gastrointestinal bleeding; endoscopy revealed chronic gastritis and duodenitis. During hospitalization in June 1990, he had an episode of lower gastrointestinal bleeding. No such bleeding episodes occurred at home.

The son had poor dentition and gingivitis around his upper molars, and his mother frequently handled the cotton-tipped swabs her son used for his oral hygiene care, although she attempted to avoid touching the cotton tips with bare hands. She reported having infrequent small cuts on her hands but had no history of dermatitis or other skin lesions. There were no blood specimens available from the son for HIV DNA sequencing.

Human Immunodeficiency Virus Transmission in Household Settings — United States Reported by: Div of HIV/AIDS and Hospital Infections Program, National Center for Infectious Diseases, CDC.

See also …

MMWR Weekly May 20, 1994 / 43(19);347,353-356

AIDS.gov HOW DO YOU GET HIV OR AIDS?

US Department of Veterans Affairs How is HIV spread?

The Cardinal Morning Commuters Beware: Offensive Smear Campaign Reported on Evergreen Ave, Arlington Heights

Resnick L, Veren K, Salahuddin SZ, Tondreau S, Markham PD. Stability and inactivation of HTLV-III/LAV under clinical and laboratory environments. JAMA. 1986 Apr 11;255(14):1887-91.

CDC Blood/Body Fluid Exposure Option [PDF] (Reporting contact: feces vs. feces visibly contaminated with blood).




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