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A Boy, a Needle . . . a Nightmare

Earlier this year, one of my 6-year-old twins found a hypodermic needle in a public restroom and stuck himself with it. Talk about an attention-getter. We were having dinner in a family-style restaurant when he asked to go to the bathroom. There he found a capped syringe resting atop the toilet paper dispenser. Naturally, he picked it up.

Understanding the basic principle behind a tube and plunger device, he first attempted to blow the cap off with air pressure. Unsuccessful in that attempt, he then pulled the cap off, and when putting it back on again, poked the needle through the side of the cap and into his finger.

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Meanwhile, back at the table, my wife wondered where our son had gone. There was a large group at our table and she had been distracted when I gave him permission to go off. When I told her where he was, she wondered why I hadn't gone with him. In turn, I gave her a look of, "What could possibly go wrong?"

When my wife sent me to check on him, he said, from inside the stall, in a fairly annoyed tone of voice, "I found a needle in here and it stuck me."

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My responding question, of course, was, "What kind of needle is it?" Followed, without pause, by, "Open this door. Let me in there."

When I saw what had stuck him, the certain slow and painful death of my son flashed through my mind right along with everything I knew about acquired immune deficiency syndrome.

Of course, flashing through many other people's minds right now is my wife's question, "Why did you let a 6-year-old go to a public restroom by himself?" -- Well, I have no viable excuse for such parentally irresponsible behavior. My explanation is that I thought my son was thoroughly versed on public restroom procedures and precautions. I thought wrong.

While I had cautioned about abduction and abuse, proper wiping and hand washing, it simply never occurred to me that sharing hypodermic needles could be a concern for 6-year-olds.

Mind you, it's not that my son hadn't been exposed to needles before. In his little lifetime he's been stuck for almost a dozen immunizations. Every one of which was presented in a lifesaving light. How could he have known that outside the doctor's office, a stick with the same sort of needle could be deadly?

We could have told him, that's how. We could have made that point clear at one or all of his immunizations.

We now have other points to make clear as well. After spending the whole next day either on the phone with doctors, nurses and infectious-disease centers or waiting for calls back, my wife and I now know a great deal about needle sticks and infectious diseases. We know that whatever damage has been done, has been done. It happened when the needle punctured the skin.

We now know that hundreds of thousands of health-care workers stick themselves putting caps back on needles every year. And that in the last 10 years, according to the Centers for Disease Control and Prevention, only 37 health-care workers have contracted the human immunodeficiency virus as a result of being stuck with HIV-infected needles.

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We know that the biggest risk our son is running is not of HIV infection, which causes the AIDS virus, but hepatitis B (hepatitis A is not passed by blood). And that in the case of hepatitis B, there is an immune globulin a person can take within 24 hours of exposure, and a vaccine as well.

We also know that both the HIV and hepatitis B viruses are extremely fragile. Neither can survive more than a few minutes outside any body. So even if the unknown person who left his needle in the restaurant restroom was indeed carrying both viruses, the chances of passing them on in this way would be slim.

In this case, we've been told by professionals and concerned friends, the unknown person was more likely a diabetic who needed a shot of insulin before eating. Someone out of his home routine who forgot to properly dispose of his spent needle.

When that more likely scenario is factored into the case, the odds of our son's being dangerously infected slip to virtually zero. Still, wanting to do something besides pray, we started our son on the three-shot series of the hepatitis B vaccine and had a blood test taken the very next day. He has since had the second shot in the vaccine series. And a follow-up blood test has revealed that the vaccine is working and there is no trace of HIV in his bloodstream.

Finally, we know that there is no known incidence of HIV appearing any later than six months after a known exposure.

And so, at this point, we take comfort in the fact that the odds are with us. The chance of my son's contracting anything but understanding from his experience are very, very small. I only wish I had given him that understanding before he was put at

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odds at all.

MICHAEL ASHCRAFT'S last piece for Sun Magazine was on kite flying.


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