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

Published online by Cambridge University Press:  02 January 2015

Gérard Krause ,
Mary Jo Trepka ,
Robert S. Whisenhunt ,
Dolly Katz ,
Omana Nainan ,
Steven T. Wiersma  and
Richard S. Hopkins
Gérard Krause*
Affiliation:
Epidemic Intelligence Service, State Branch, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia Bureau of Epidemiology, Florida Department of Health, Tallahassee, Florida
Mary Jo Trepka
Affiliation:
Miami-Dade County Health Department, Miami, Florida
Robert S. Whisenhunt
Affiliation:
Miami-Dade County Health Department, Miami, Florida
Dolly Katz
Affiliation:
Bureau of Epidemiology, Florida Department of Health, Tallahassee, Florida
Omana Nainan
Affiliation:
Hepatitis Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
Steven T. Wiersma
Affiliation:
Bureau of Epidemiology, Florida Department of Health, Tallahassee, Florida
Richard S. Hopkins
Affiliation:
Bureau of Epidemiology, Florida Department of Health, Tallahassee, Florida
*
Infektionsepidemiologie, Robert Koch-Institut, Seestr. 10, 13353 Berlin, Germany
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Abstract

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.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 2 , February 2003 , pp. 122 - 127
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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