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Nosocomial Transmission of Hepatitis C Virus Associated With the Use of Multidose Saline Vials

Gérard Krause , MD, DrMed, Mary Jo Trepka , MD, MPH, Robert S. Whisenhunt , MD, MPH, Dolly Katz , PhD, Omana Nainan , PhD, Steven T. Wiersma , MD, MPH and Richard S. Hopkins , MD, MSc
Infection Control and Hospital Epidemiology
Vol. 24, No. 2 (February 2003), pp. 122-127
DOI: 10.1086/502176
Stable URL:
Page Count: 6
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Nosocomial Transmission of Hepatitis C Virus Associated With the Use of Multidose Saline Vials
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OBJECTIVE.  To identify the source of an outbreak of acute hepatitis C virus (HCV) infection among 3 patients occurring within 8 weeks of hospitalization in the same ward of a Florida hospital during November 1998. DESIGN.  A retrospective cohort study was conducted among 41 patients hospitalized between November 11 and 19, 1998. Patients’ blood was tested for antibodies to HCV, and HCV RNA–positive samples were genotyped and sequenced. RESULTS.  Of the 41 patients, 24 (59%) participated in the study. HCV genotype 1b infections were found in 5 patients. Three of 4 patients who received saline flushes from a multidose saline vial on November 16 had acute HCV infection, whereas none of the 9 patients who did not receive saline flushes had HCV infection (P = .01). No other significant exposures were identified. The HCV sequence was available for 1 case of acute HCV and differed by a single nucleotide (0.3%) from that of the indeterminate case. CONCLUSION.  This outbreak of HCV probably occurred when a multidose saline vial was contaminated with blood from an HCV‐infected patient. Hospitals should emphasize adherence to standard procedures to prevent blood‐borne infections. In addition, the use of single‐dose vials or prefilled saline syringes might further reduce the risk for nosocomial transmission of blood‐borne pathogens.

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