The Firing Line Forums - View Single Post

January 14, 1999, 03:23 PM

Dennis-
Thanks for the clarification. You will be happy to know that, yes indeed, I have taken a chill pill.

Perhaps we are mincing words, but there is little room for disagreement in the evaluation of risk. There is however much room for discussion on an individuals tolerance to the risk. It is my objective to bring enlightenment and perspective to the risk involved and dissolve some of the disinformation, fear, and paranoia.

You stated that you would only go mouth to mouth with 6 people with very rare exceptions. To believe that is fine. To say that in a class you are teaching shows an extreme bias, which is not based on the facts presented. The reason I wrote the post was to counter that thought.

First let me say that I am purposefully vague about my profession on line. However if any of the regulars here at TFL would like specifics, I would be happy to email you and give the "ad nauseum". I generally like my ideas to be judged on content and not percieved expertise due to my background.

My point in bringing up kissing on a first date is that as well as you think you know someone- you don't. That girl your kissing is a representation of the general public- like it or not. Therefore mouth to mouth with the general public, with some exceptions(see individual described below, hooker, person with track marks or needle sticking out of arm, pulled out of a crack house, etc...), has minimal/negligible risk and even in above settings is smaller than most would think.

I believe I have a very real & experienced perception of the risk of infectious disease. I am neither "brave" or foolhardy(in this case anyway- more often foolhardy than brave). I would be very reticent about a liplock on a dishelved, stinky, yellow(from disease), blood splattered, suppurating ulcer laden individual. In fact, that person is probably not going to recieve a liplock from me, flimsy barrier or not. However given someone who does not have obvious extreme disease(or above circumstances) will recieve my help, flimsy barrier or no, because the risk is low. By the way I would not place much confidence in the barriers, as you know things get pretty sloppy and wet when it gets going- CPR that is. Better than nothing though.

I cannot refute your statistics about the # of EMS dying from disease contracted on the job(nor would I want to- true or not, it serves to remind us to be carefull) because I have no source, you have given none. But regardless, health professionals daily perform invasive procedures and are exposed to splurting fluids which skew the risk from a single mouth to mouth exposure by a good samaritan.

Point taken about the pnuemonia, i.e. be carefull! But poor example. The most common route of transmission of pnuemonia in a healthy individual is your own mouth/nose. Pnuemonia is not typically transmitted people to people. It is caused by viruses and bacteria which colonize your mouth and nose intermittently. Then if there is a breakdown of defenses, it infects you. That is why people in hospitals are not quarantined with pnuemonia(a very few bugs excepted). The vast majority are not "contagious" person to person(for reference- Robbins pathologic basis of disease, Cecils or Harrison's internal medicine texts are a good start). On top of this it is usually the very old and those with other major illness that die of pnuemonia.

Please do not misunderstand, there are bugs you can theoretically catch which have been pointed out previously(HIV, hep B,hep C), from CPR - but risk is very small. TB may be transmissable by CPR(I do not know) but I feel the risk would be small. I base this on the fact TB is not appreciably present in saliva, just sputum from deep within the lungs- in some people. If the TB is dormant(usually the case) the organism is "walled off" and more difficult to transmit. Usually you need to be in close & intimate quarters for a prolonged period of time to get TB. Given all of this I would never perform mouth to mouth on a person I knew for a fact had any of the above diseases. But when you multiply the odds of a person having these diseases with their tranmisabillity- well, you get the idea.

enjoy,

Olazul

January 14, 1999, 03:23 PM	#27
olazul Guest Posts: n/a	Dennis- Thanks for the clarification. You will be happy to know that, yes indeed, I have taken a chill pill. Perhaps we are mincing words, but there is little room for disagreement in the evaluation of risk. There is however much room for discussion on an individuals tolerance to the risk. It is my objective to bring enlightenment and perspective to the risk involved and dissolve some of the disinformation, fear, and paranoia. You stated that you would only go mouth to mouth with 6 people with very rare exceptions. To believe that is fine. To say that in a class you are teaching shows an extreme bias, which is not based on the facts presented. The reason I wrote the post was to counter that thought. First let me say that I am purposefully vague about my profession on line. However if any of the regulars here at TFL would like specifics, I would be happy to email you and give the "ad nauseum". I generally like my ideas to be judged on content and not percieved expertise due to my background. My point in bringing up kissing on a first date is that as well as you think you know someone- you don't. That girl your kissing is a representation of the general public- like it or not. Therefore mouth to mouth with the general public, with some exceptions(see individual described below, hooker, person with track marks or needle sticking out of arm, pulled out of a crack house, etc...), has minimal/negligible risk and even in above settings is smaller than most would think. I believe I have a very real & experienced perception of the risk of infectious disease. I am neither "brave" or foolhardy(in this case anyway- more often foolhardy than brave). I would be very reticent about a liplock on a dishelved, stinky, yellow(from disease), blood splattered, suppurating ulcer laden individual. In fact, that person is probably not going to recieve a liplock from me, flimsy barrier or not. However given someone who does not have obvious extreme disease(or above circumstances) will recieve my help, flimsy barrier or no, because the risk is low. By the way I would not place much confidence in the barriers, as you know things get pretty sloppy and wet when it gets going- CPR that is. Better than nothing though. I cannot refute your statistics about the # of EMS dying from disease contracted on the job(nor would I want to- true or not, it serves to remind us to be carefull) because I have no source, you have given none. But regardless, health professionals daily perform invasive procedures and are exposed to splurting fluids which skew the risk from a single mouth to mouth exposure by a good samaritan. Point taken about the pnuemonia, i.e. be carefull! But poor example. The most common route of transmission of pnuemonia in a healthy individual is your own mouth/nose. Pnuemonia is not typically transmitted people to people. It is caused by viruses and bacteria which colonize your mouth and nose intermittently. Then if there is a breakdown of defenses, it infects you. That is why people in hospitals are not quarantined with pnuemonia(a very few bugs excepted). The vast majority are not "contagious" person to person(for reference- Robbins pathologic basis of disease, Cecils or Harrison's internal medicine texts are a good start). On top of this it is usually the very old and those with other major illness that die of pnuemonia. Please do not misunderstand, there are bugs you can theoretically catch which have been pointed out previously(HIV, hep B,hep C), from CPR - but risk is very small. TB may be transmissable by CPR(I do not know) but I feel the risk would be small. I base this on the fact TB is not appreciably present in saliva, just sputum from deep within the lungs- in some people. If the TB is dormant(usually the case) the organism is "walled off" and more difficult to transmit. Usually you need to be in close & intimate quarters for a prolonged period of time to get TB. Given all of this I would never perform mouth to mouth on a person I knew for a fact had any of the above diseases. But when you multiply the odds of a person having these diseases with their tranmisabillity- well, you get the idea. enjoy, Olazul