This virus can spread through sexual contact, unsterile needles, and blood transfusions. The dream portrays Freud's colleague giving Irma an unsterile injection. Dysentery due to unsterile conditions and utensils further weakened many men in the camp. The FGM was performed with a rusty knife on the unsterile floor of a hut. There may be infection as a result of unsterile delivery. There's also been five outbreaks in renal dialysis because of unsterile equipment.