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Colleagues we are about to have a civil war at our hydrotherapy center and the opinion of the podiatry department has been sought . The issue is - should people with VP's be allowed to participate in hydrotherapy sessions ? The evidence base is a little thin on either a yeah or neigh ? My initial thought was that if the pool was kept at appropriate chlorinated levels, it would help eradicate the virus and thus further contamination . It would also be my suggestion that appropriate showering precautions be followed as well. What would be your opinions?

If they banned people for a simple papilloma lesion, they would also need to justify why not banning people with suspected:

* fungal infections of the nail and skin
* UTI's
* conjuntivitis
* URTI's

etc etc - the list goes on.

This is non-policable, and there is no evidence either way.

Encourage them to stick a Band-aid over them.

LL

Please provide more info.....for what conditions are you using the hydrotherapy???? Is this pool therapy or a foot bath?? If the later, how do you sterilize between patients???

LL - Bandaids are not allowed in the pool !

Scorpio622 This is a hydrotherpay pool . Interesting the issue of a foot bath as there was research recently which talked about the high incidence of cross infections with people accessing beauty therapy services and use of items such as foot spa's .

Encourage the patient to paint the vp with clear nail varnish to keep the skin in tact, it works a treat!! I had a vp for 13 years and never took any precautions and not one member of my family picked it up. I don't think they can be caught as easily as people think! Luckylisfranc is quite right, if you stopped people with vp from using hydrotherapy, where do you stop!

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This is a good idea. A strip of duct tape will work as well and may be easier.

IMHO, hydrotherapy has very little therapuetic value for musculoskeletal problems as well as dermatolgic conditions with the exception of softening dystrophic nails for debridement. It's not worth the cross infection risk as well as the time / water bill.

This is the trouble with VP's. Without being able to culture a virus in a lab and see how it behaves in vitro how can you say whether it is contagious or not.

Anecdotally people who swim (kids in particualar) do seem to get more. This is not, however, necessarily evidence of contagion! Could be that micro abrasions in the skin from non slip surfaces make the feet more vunerable to lesions from naturally occuring skin flora and fauna. Could be demographic. We just don't know.

Be great to find a kid with vps, get them to tap dance on a wet non slip surface than march a random 200 other kids over the area and see what happens. Ethics commitees can be so petty sometimes!
I say cover em up and hope for the best. Compeed works quite well if you can't get the patient to agree to duct tape of the pool to agree to band aids!

Good luck with that. The curse of "everyone knows" is a hard thing to fight!

Regards
Robert

How bizarre? Are they going to be doing random foot inspections? Are they going to be trained in DDx of a Wart vs a corn?

I think a look at the bigger picture is warranted and the benefits of Hydro outweighing the possibility of someone possible contracting a VP that may or may not have come from the pool environment.

Good luck! Personally I'd be running far far away from such an argument.