Reuters Health Information (2005-03-11): Glucose monitoring tied to HBV transmission at nursing homes
Glucose monitoring tied to HBV transmission at nursing homes
Last Updated: 2005-03-11 15:38:31 -0400 (Reuters Health)
NEW YORK (Reuters Health) - The spread of hepatitis B
virus (HBV) at three long-term-care facilities in the US seems to have
resulted from the sharing of blood glucose monitoring equipment,
according to findings in the March 11th Morbidity and Mortality Weekly
The outbreaks, which occurred in 2003 and 2004, involved centers in
Mississippi, California, and North Carolina. However, this is not the
first time that HBV transmission has been tied to the sharing of
glucose monitoring supplies, study co-author Dr. Anthony Fiore, from
the Centers for Disease Control and Prevention in Atlanta, told Reuters
"We've reported on these types of outbreaks numerous times in the
past," Dr. Fiore noted. The fact that they keep happening suggests that
recommended sterility practices need to be reinforced, he added.
The outbreak in Mississippi involved a nursing home with two fatal
cases of acute HBV infection. The resulting investigation revealed that
15 residents had acute HBV infection and all but one received routine
fingersticks for blood glucose testing. Staff interviews indicated that
although the needles themselves were not shared, other equipment was.
In California, four diabetic residents at an assisted living center
were diagnosed with acute HBV infection. Eight cases were eventually
uncovered and all were linked to fingersticks performed by the nursing
staff. Once again, it appeared that glucose monitoring equipment was
being shared by the residents.
The North Carolina outbreak started with one case of HBV infection
detected in May 2003. Subsequent testing of all residents uncovered a
total of 11 cases of acute infection. Although cases were not confined
to patients tested for glucose, such patients were 6.9-times more
likely to be infected than those who had not been tested. Staff
interviews revealed that glucometers were often shared between patients
and seldom cleaned.
"The common theme that ran through these outbreaks is that diabetes
care supplies were being used on multiple patients," Dr. Fiore said.
"Still, it's not exactly clear in any of the outbreaks which practices
actually transmitted HBV."
Mor Mortal Wkly Rep CDC Surveill Summ 2005;54:220-223.