Infection Control and Hospital Epidemiology Publication Info
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A Large Nosocomial Outbreak of Hepatitis C and Hepatitis B Among Patients Receiving Pain Remediation Treatments
Formats Available in JSTOR: PDF
Abstract(back to top)
BACKGROUND AND OBJECTIVE. In August 2002, the Oklahoma State Department of Health received a report of six patients with unexplained hepatitis C virus (HCV) infection treated in the same pain remediation clinic. We investigated the outbreak’s extent and etiology.
DESIGN, SETTING, AND PARTICIPANTS. We conducted a retrospective cohort study of clinic patients, including a serologic survey, interviews of infected patients, and reviews of medical records and staff infection control practices. Patients received outpatient pain remediation treatments one afternoon a week in a clinic within a hospital. Cases were defined as HCV or hepatitis B virus (HBV) infections among patients who reported no prior diagnosis or risk factors for disease or reported previous risk factors but had evidence of acute infection.
RESULTS. Of 908 patients, 795 (87.6%) were tested, and 71 HCV‐infected patients (8.9%) and 31 HBV‐infected patients (3.9%) met the case definition. Multiple HCV genotypes were identified. Significantly higher HCV infection rates were found among individuals treated after an HCV‐infected patient during the same visit (adjusted odds ratio [AOR], 6.2; 95% confidence interval [CI95], 2.4–15.8); a similar association was observed for HBV (AOR, 2.9; CI95, 1.3–6.5). Review of staff practices revealed the nurse anesthetist had been using the same syringe–needle to sequentially administer sedation medications to every treated patient each clinic day.
CONCLUSIONS. Reuse of needles–syringes was the mechanism for patient‐to‐patient transmission of HCV and HBV in this large nosocomial outbreak. Further education and stricter oversight of infection control practices may prevent future outbreaks.
Bibliographic Information(back to top)
- A Large Nosocomial Outbreak of Hepatitis C and Hepatitis B Among Patients Receiving Pain Remediation Treatments
- R. Dawn Comstock , PhD, Sue Mallonee , RN, MPH, Jan L. Fox , RN, Ronald L. Moolenaar , MD, MPH, Tara M. Vogt , PhD, Joseph F. Perz , DrPH, Beth P. Bell , MD, MPH and James M. Crutcher , MD, MPH
- Infection Control and Hospital Epidemiology
- Vol. 25, No. 7 (July 2004) (pp. 576-583)
Notes and References(back to top)
This item contains 1 note(s).
Notes
Dr. Comstock, Ms. Mallonee, Ms. Fox, and Dr. Crutcher are from the Oklahoma State Department of Health, Oklahoma City, Oklahoma. Drs. Comstock and Moolenaar are from the Epidemiology Program Office, Division of Applied Public Health Training, and Drs. Vogt, Perz, and Bell are from the National Center for Infectious Diseases, Division of Viral Hepatitis, Centers for Disease Control and Prevention, Atlanta, Georgia.Address reprint requests to R. Dawn Comstock, PhD, Oklahoma State Department of Health, 1000 N.E. 10th Street, Oklahoma City, OK 73117.The authors thank Pat Scott and Joyce Lane for their assistance with medical chart abstraction and follow‐up telephone interviews, Nancy Green for her assistance with preparing the manuscript, and Olivia Brown for data entry.
Items Citing this Item (back to top)
2 item(s) in JSTOR cite this item
- Saleem Kamili , PhD; Kris Krawczynski , MD, PhD; Karen McCaustland , BS; Xiaofang Li , MD; Miriam J. Alter , PhDVol. 28, No. 5 (May 2007) pp. 519-524Stable URL: http://www.jstor.org/stable/10.1086/513727
- Jeanne‐Marie Germain , MD; Anne Carbonne , MD; Valérie Thiers , PhD; Hélène Gros , MD; Sylvie Chastan , MD; Elisabeth Bouvet , MD; Pascal Astagneau , MD, PhDVol. 26, No. 9 (September 2005) pp. 789-792Stable URL: http://www.jstor.org/stable/10.1086/502618