To determine the incidence of hepatitis C virus (HCV) infection among healthcare workers (HCWs) at a university hospital, the proportion of HCWs having non-A, non-B hepatitis (NANBH) who were anti-HCV positive, and the rate of HCV transmission following a HCV-positive needlestick injury.

Longitudinal analysis of a dynamic (cohort) population.

From 1980 through 1989, HCWs who had clinical NANBH were identified, and from 1987 through 1989, HCWs who reported a blood or body fluid exposure and the patients who were the source of the exposure were screened for antibodies to HCV.

A 732-bed, university hospital and outpatient clinics.

Over the 10-year period, six cases of occupationally acquired NANBH were observed, for an incidence of 21 cases per 100,000 HCWs per year (standardized incidence ratio, 2.96; 95% confidence interval [CI95], 1.83 to 4.36). Four of the six cases were confirmed to be HCV infection. From 1987 through 1989, 176 (12.7%) of 1,387 patients who were the source of an exposure were anti-HCV positive. Exposures that occurred in the emergency department were more likely to be anti-HCV positive than were exposures from all other locations (relative risk [RR] = 1.7; P= 0.009). Of HCWs who had an HCV-positive needlestick injury and whose serum had been tested for anti-HCV at least 5 months after the exposure, 3 (6.0%) of 50 seroconverted. From 1987 through 1989, the incidence of HCV infection among HCWs was 54 cases per 100,000 HCWs per year.

The incidence of clinical NANBH among HCWs in this study is approximately three times higher than that of non-HCWs. HCWs are at significant risk for exposure to and acquisition of HCV.

Rotaviruses, which are among the most important infectious causes of acute diarrhea, frequently cause outbreaks in hospitals, daycare centers, schools, and nursing homes. These viruses can remain viable on inanimate surfaces for many days and infectious rotavirus particles have been recovered from hands and a variety of surfaces and objects. Casual contact can lead to the transfer of these viruses from contaminated to clean surfaces. Therefore, animate and inanimate surfaces may play a complementary role in the spread of these viruses.

In this study, we compared the capacity of a disinfectant spray (0.1% o-phenylphenol and 79% ethanol), a domestic bleach (6% sodium hypochlorite diluted to give 800 ppm free chlorine), a quaternary ammonium (quat)-based product (7.05% quat diluted 1:128 in tap water), and a phenol-based product (14.7% phenol diluted 1:256 in tap water) to interrupt the transfer of a human rotavirus (DS-1) from stainless steel disks to fingerpads of volunteers with a 10-second contact at a pressure of 1 kg/cm2.

Each disk received a 10 μL inoculum containing 1.0 × 104 to 7.0 × 104 plaque-forming units (PFU) of the virus suspended in 10% feces. The inoculum was dried for 1 hour and overlaid with 20 μL of either tap water or the test product.

A 10-minute exposure to tap water reduced the virus titer by 52.3% ± 11.7%. The disinfectant spray was able to reduce virus infectivity by >99.99% after a contact of 3 to 10 minutes. The loss in virus infectivity after a 10-minute treatment with the quat was almost the same (54.7% ± 17.8%) as seen with tap water. The activities of the bleach and the phenolic were very similar with losses in PFU of 97.9% ± 0.4% and 95% ± 5.36%, respectively. No detectable virus was transferred to fingerpads from disks treated with disinfectant spray, the bleach, and the phenolic. Contact of the fingerpads with tap water- or quat-treated disks resulted in the transfer of 5.6% ± 1.1% and 7.6% ± 2.5% of the remaining infectious virus, respectively.

These findings emphasize the care needed in the selection of environmental surface disinfectants in preventing the spread of rotaviral infections.