Originally Posted by zylph
I would tread very carefully if I were you. Hepatitis B infection status is covered under the Americans with Disabilities Act. If it's not a completely mutual decision for your nanny to leave, you could have a fairly serious lawsuit on your hands.
Hepatitis B and C are both fairly serious diseases - B a little more so than C, as there is no treatment to clear the virus in a chronically infected person. HBV is also more transmissible - the minimum infectious dose is about 10 viral particles (the typical rule for the bloodborne pathogens is 0.2, 2, 20 for HIV, HCV, HBV - meaning that 0.2% of people exposed to HIV+ blood will be infected and 20% of people exposed to HBV blood will). However, most people will clear HBV spontaneously and develop immunity - 95% of adults clear HBV, as opposed to 20% for HCV.
There is really nothing to worry about as long as your nanny is well acquainted with universal precautions (she really should be). People with HCV/HBV/HIV are not lepers and should not be treated as such. The risk to your child is infinitesimally small as long as your nanny is careful (if she's not, that's a firable offense). I would urge you to get your child vaccinated anyway, but that's less to do with your nanny than other situations that might crop up later.
ADA applies to employers with 15 or more employees. So unless you have a whole slew of nannies working with dd, you should be fine in that regard.
I wouldn't treat someone as a leper. They would be welcome in my home and I would treat them with respect. However, I would not leave them unattended with my child every day. Yes, we would hope that the nanny would be careful, but there is no guarantee that she will be. Even if she can be fired for not being careful, that will serve as little solace if something happens. Plus, accidents happen.
And I would not vax my 10 month old for a disease that is primarily transmitted through IV drug use and sexual contact with an infected person.