Holy Hormones Journal: First no one heard of HPV until Merck came out with their vaccine, Gardasil. The FDA noted in their 2006 VRBPAC report that if a woman was previously exposed to HPV and she was vaccinated the vaccine’s efficacy decreased by 44.6% and her chances of developing cervical cancer -increased by the same amount.
And now HPV contamination in clinical settings? This is not the first time clinical contamination has been exposed. Dr. David Lewis, former EPA microbiologist, and author of Science for Sale, fought hard to bring new regulations for equipment sterilization to dental offices and to doctors performing an endoscopy. It appears that bacteria and other fecal matter can get caught up in minute places in the equipment. If not sterilized correctly after each use, that matter can be transmitted to the next patient. Talk about a plague.
How many women and girls – men and boys have been exposed to this infection in their doctor’s office. How many girls and boys were then vaccinated? Are we facing a major HPV-related cancer epidemic?
Human Papillomavirus (HPV) Contamination of Gynaecological Equipment
Sex Transm Infect. 2016;92(1):19-23.
Abstract and Introduction
Objective The gynaecological environment can become contaminated by human papillomavirus (HPV) from healthcare workers’ hands and gloves. This study aimed to assess the presence of HPV on frequently used equipment in gynaecological practice.
Methods In this cross-sectional study, 179 samples were taken from fomites (glove box, lamp of a gynaecological chair, gel tubes for ultrasound, colposcope and speculum) in two university hospitals and in four gynaecological private practices. Samples were collected with phosphate-buffered saline-humidified polyester swabs according to a standardised pattern, and conducted twice per day for 2 days. The samples were analysed by a semiquantitative real-time PCR. Statistical analysis was performed using Pearson’s χ2 test and multivariate regression analysis.
Results Thirty-two (18%) HPV-positive samples were found. When centres were compared, there was a higher risk of HPV contamination in gynaecological private practices compared with hospitals (OR 2.69, 95% CI 1.06 to 6.86). Overall, there was no difference in the risk of contamination with respect to the time of day (OR 1.79, 95% CI 0.68 to 4.69). When objects were compared, the colposcope had the highest risk of contamination (OR 3.02, 95% CI 0.86 to 10.57).
Conclusions Gynaecological equipment and surfaces are contaminated by HPV despite routine cleaning. While there is no evidence that contaminated surfaces carry infectious viruses, our results demonstrate the need for strategies to prevent HPV contamination. These strategies, based on health providers’ education, should lead to well-established cleaning protocols, adapted to gynaecological rooms, aimed at eliminating HPV material.
Human papillomaviruses (HPVs) are small double-stranded DNA viruses with a circular genome, which is enclosed in a naked capsid. HPVs infect the stratified epithelium of the skin, of the oral cavity and of the anogenital tract by accessing keratinocytes through micro-wounds and lesions. The majority of infections are cleared within 2 years. However, persistence of HPV and the associated chronic infection play a major role in the development of cervical cancer. Therefore, HPV is estimated to be responsible for up to 99% of cervical cancers, 90% of anal cancers, 65% of vaginal cancers, 50% of vulvar cancers and 45%–90% of oropharyngeal cancers. HPVs are classified into high-risk HPV (HR-HPV) with malignant potential and low-risk HPV (LR-HPV) causing benign lesions.
There is conflicting evidence for HPV transmission. While skin-to-skin and mucosa-to-mucosa contact, which is predominantly by sexual intercourse, is the most frequent route of transmission, other routes might be involved. Several studies have highlighted non-sexual HPV transmission such as vertical transmission from mother to infant, possibly through the amniotic fluid or the placenta or via contact with the maternal genital mucosa during delivery.
Besides direct human transmission of HPV by sexual intercourse, infection may also result from contact with contaminated equipment at gynaecological examination rooms. HPV can persist in various environmental conditions and resist disinfection by desiccation and ethanol because of its capsid properties. Therefore, the possibility of horizontal transfer of HPV cannot be excluded.[9–11] HPV has been detected under fingernails of patients affected with genital warts and in their underwear. Furthermore, HPV is also detected on several medical instruments, such as vaginal ultrasound probes and cryoguns.[13,14] These data support the notion that gynaecological facilities might confer a risk of horizontal transfer, being frequently visited by infected patients. In addition, gynaecological examinations may cause micro-trauma of the genital mucosa favouring HPV infection.
This study aimed to assess whether HPV can be identified on certain types of inanimate surfaces and objects that are commonly used in gynaecological care. The panel of fomites that we selected has not been previously studied, and these are used in an everyday gynaecological practice.