Spitting and Hep B & C

Spitting is gross, but it cannot transmit hepatitis B or C.

If you have recently seen news stories about hepatitis B or C being spread from spitting, read on to get the facts.

What the media says

Recent reports describe bus drivers and police officers being spat at, whilst suggesting substantial risks of catching viral hepatitis from saliva. It has also been implied that people must wait six months before they get their hepatitis blood test results.

For instance, one article gives examples of police officers who had “half a year of uncertainty, anxiety and stress” whilst awaiting test results. Another article describes how a bus driver was “isolated from his own family at home until he was clear of saliva-borne diseases.”

Misinformation, stigma and discrimination

This article does not excuse spitting assaults such as those portrayed by the media, nor does it aim to devalue the stress experienced by the person on the receiving end. But it does aim to share the truth about viral hepatitis transmission.

We know that many people living with hepatitis B and C (known as blood-borne viruses) already live with stigma and discrimination.

If risks of transmission are incorrectly reported, whether through fear or lack of clear information, society’s understanding of viral hepatitis can become distorted, increasing stigma and discrimination. Consequently, people living with viral hepatitis may be:

(a) more likely to experience mental and physical health problems, and

(b) less likely to seek treatment.

How hepatitis B and C are transmitted, and the real risk from spitting

Hepatitis C is transmitted when a sufficient amount of blood from an infected person enters the bloodstream of another person. Hepatitis B is also spread this way, as well as sexually.

You cannot contract hepatitis B or C through casual contact such as touching, kissing, hugging or sharing food. You also cannot contract hepatitis B or C from blood or body fluids having contact with intact skin.

The likelihood of saliva containing a substantial amount of blood and it passing into the recipient’s bloodstream, such as through an open wound, or the eyes or mouth, is so small, that the risk of hepatitis from spitting is near-zero.

This negligible risk of spread by spitting is evidenced by a 2018 review which looked at all known studies worldwide of spitting assaults on emergency service workers. It found:

• There was only one plausible case of hepatitis B transmission, where a patient with hepatitis B spat in the eye of an unvaccinated nurse.

• There were no cases of hepatitis C transmission from spitting.

• The risk of an unknown assailant (in the general population) being hepatitis B or C positive AND being highly infective was 1 in 500, at the most.

How to protect yourself

You can get vaccinated against hepatitis B. All healthcare workers and emergency personnel including police officers should be vaccinated against hepatitis B.

Even if an unvaccinated adult contracts hepatitis B, they are highly likely to clear the infection without treatment.

There is no vaccination for hepatitis C but there is medicine that cures hepatitis C in 8 to 12 weeks. The medicines are tablets and most people have no side effects.

What should you do if you are exposed to saliva

Remember, the chances of getting hepatitis B or hepatitis C from being spat at are near zero. Blood tests typically detect hepatitis B virus in 1–3 months, and hepatitis C in 3 months.

You can get Post Exposure Prophylaxis (PEP)—a medication taken after exposure to hepatitis B (or HIV) if you are not immune, which reduces the risk of infection. Although there is no PEP for hepatitis C, there is a very effective cure.

Dr Alice Lam, 4 September 2022, accessed from Hepatitis Australia’s Website.

The National Hepatitis Infoline provides free, confidential information and support: 1800 437 222.

By Isaac Tye