New Health Study Focuses on Hepatitis Spread
January 9, 2009
More than 60,000 US patients were advised to seek testing for hepatitis B and C during the past 10 years due to the failure of non-hospital health care providers to follow basic infection control practices, a new CDC report says.
The study, the agency's first full review during the past decade of the link between viral hepatitis outbreaks and health care outside of hospitals, "is a wake-up call," said Dr. John Ward, director of CDC's Division of Viral Hepatitis. "Thousands of patients are needlessly exposed to viral hepatitis and other preventable diseases in the very places where they should feel protected."
Transmission of hepatitis B or C through health care in the United States has been considered uncommon. Yet the report identifies 33 such outbreaks that occurred outside hospitals in 15 states during the study period. Outbreaks took place in outpatient clinics (12), hemodialysis centers (six), and long-term care facilities (15), infecting a total of 450 patients with hepatitis B or C. Included in the review was the 2008 hepatitis C outbreak linked to two now-closed Las Vegas endoscopy clinics.
"In each setting, the putative mechanism of infection was patient-to-patient transmission through failure of health care personnel to adhere to fundamental principles of infection control and aseptic technique (for example, reuse of syringes or lancing devices,)" according to the report.
"Difficult to detect and investigate, these recognized outbreaks indicate a wider and growing problem as health care is increasingly provided in outpatient settings, in which infection control training and oversight may be inadequate. A comprehensive approach involving better viral hepatitis surveillance and case investigation, health care provider education and training, professional oversight, licensing, and public awareness is needed to ensure that patients are always afforded basic levels of protection against viral hepatitis transmission," the report concludes.
The review, "Non-hospital Health Care-Associated Hepatitis B and C Virus Transmission: United States, 1998-2008," was published in the Annals of Internal Medicine (2009;150(1):33-39).
Las Vegas Sun; 01.06.2009