Myths about how hep C is spread
Hep C is NOT passed on through touching, kissing or hugging someone else, or by sneezing or coughing. It is NOT spread by sharing food, crockery, cutlery, towels, bathrooms or toilets. There is no need to wash your clothes separately. Insects like mosquitoes or fleas do not transmit hep C.
How do you get hep C?
Hepatitis C (hep C) is a virus that lives in the blood, and is transmitted (passed on from one person to the next) when infected blood from one person gets into someone else’s blood stream. Even invisible (microscopic) amounts of blood can transmit hep C.
This can happen in quite a few different ways.
Sharing or reusing other people’s needles and syringes. Very high risk
The highest risk comes from sharing the needle and syringe. Even if you injected just once a long while ago, you may have been at risk of getting hep C. [i]
Sharing or reusing other people’s drug injecting equipment. High risk
Aside from needles and syringes, all equipment used to prepare the injection can spread hep C. This includes spoons, filters, water, tourniquets and swabs. Even tiny amounts of blood that cannot be seen by the naked eye can contain the virus. It can also be passed on through blood on people’s fingers or by sharing areas such as tables or benchtops where other people’s equipment is sitting.
Tattooing, body piercing, and other beauty procedures. Moderate to low risk
Tattooing and body piercing can be a risk because they involve equipment coming into contact with blood that may be infected. If infected equipment is not sterilised properly, it can spread the virus to another person. The risk increases in situations where it might be hard to sterilise equipment properly, such as prison and ‘backyard’ situations.
Manicures and pedicures (cleaning and filing of fingernails and toenails) also carry a possible risk of spreading the virus from one person to another through infected equipment, if it has not been properly sterilised between clients.
The risk for all of the above might increase if you have them performed in a developing country where rules about health standards may not exist, or workers may not have good knowledge about sterilisation and infection control. Also, because the rate of hepatitis virus among the population may be higher in developing countries, the risk of equipment coming into contact with infected blood also increases.
Medical care in developing countries. Moderate to low risk
In some developing countries, the blood used for transfusions is not properly screened for hep C. Also, surgical equipment is sometimes not well sterilised, which means that there is a risk it may still have very small amounts of the hep C virus on it and can infect other people. In Australia, the blood used for transfusions has been screened for hep C since 1990, and is very safe. But there is a low risk in Australia that some procedures involving blood may be performed by workers who do not have a good understanding of sterile procedure and infection control.
Sharing of drug snorting equipment. Low risk
When people use a straw for sniffing a drug, the lining inside the nose can easily be damaged and small amounts of blood can get onto the straw. If the straw is passed to another person to use, this blood (which may have the virus in it) can get in the second person’s bloodstream if the straw damages their nasal lining as well.
Sexual activity. Low risk
Transmission of hepatitis C through sex is unlikely – hepatitis C is not classified as a sexually transmissible infection (STI) and is not in vaginal fluids or semen. But there is a possibility of hepatitis C transmission if there are cuts or open wounds around the genital area of both people during sex. The risk becomes higher during unprotected anal sex, especially if you have problems with your immune system or if you have other STIs.
Parent to baby transmission Low risk.
There is a low risk of hep C being passed on from mother to baby before or during birth, but this is not common. About 94% of babies born to hep C-positive mothers will not have hep C.[ii] Fathers who are hep C-positive cannot pass the virus on to their babies either when the baby is conceived, or during pregnancy. The way the baby is born does not affect the risk either (natural birth, or by operation).
Sharing of household items. Very low risk
It is very rare for hep C to be transmitted through the use of most household items, but it is best not to share razor blades, tweezers and toothbrushes. Brushing your teeth can cause bleeding gums, so sharing your toothbrush can cause possible blood-to-blood contact. Razor blades and tweezers can also possibly lead to blood-to-blood contact between people.
Needle-stick injuries in the community. Very low to extremely low risk
A needle-stick injury is an accidental injury from a needle containing another person’s blood. It can happen to medical staff in hospitals or surgeries, but also to members of the public who come across used syringes that have been thrown away in public places. The chance of catching hep C this way is possible in theory, but the risk is extremely low.
Breastfeeding. Extremely low risk
Breastfeeding does not spread hep C, and the virus is not transmitted through breast milk. However, because hep C is spread by blood, if your nipples are cracked and bleeding, you should stop nursing temporarily on that breast and consult a midwife. Mothers are strongly encouraged to breastfeed whether or not they have hep C.
Other practices that involve blood
Traditional practices using razor blades, knives or needles can be a risk for spreading the hep C virus. ‘Blood brother’ rituals involve direct blood-to-blood contact and therefore carry a very high risk of infection if one person has the hep C virus. Sharing instruments for branding or self-harming also carry a high risk of blood-to-blood contact
Last review June 2018
i.The Kirby Institute. Hepatitis B and C in Australia Annual Surveillance Report 2016.
ii.The Kirby Institute, University of New South Wales Australia, Sydney.