Public Health

Reuse of contaminated supplies to blame for HCV outbreak at oncology clinic

Last Updated: 2005-06-06 17:00:15 -0400 (Reuters Health)

NEW YORK (Reuters Health) - A large outbreak of hepatitis C virus (HCV) that occurred at a hematology/oncology clinic a few years ago seems to have resulted from the reuse of contaminated syringes and saline bags, according to a report in the Archives of Internal Medicine for June 7.

The outbreak, which was first reported in September 2002, occurred at an outpatient clinic in eastern Nebraska. In the present study, Dr. Alexandre Macedo de Oliveira, from the Centers for Disease Control in Atlanta, and colleagues describe their investigation of the outbreak.

The researchers contacted 613 clinic patients who visited the clinic during the likely exposure period, March 2000 through December 2001. Of these patients, 494 were tested for HCV infection.

Ninety-nine patients were identified with new HCV infections, all of whom had started treatment at the clinic before July 2001, the investigators note.

All 95 samples that were genotyped showed the same HCV strain: genotype 3a. The researchers believe the virus came from a patient with chronic hepatitis C who started treatment at the clinic in March 2000.

Receipt of saline flushes was identified as a significant predictor of HCV infection, the report indicates. "Shared saline bags were probably contaminated when syringes used to draw blood from venous catheters were reused to withdraw saline solution," the authors note. This procedure was corrected in July 2001, they add.

"This report is a reminder that all suspected cases of healthcare-associated bloodborne infections deserve vigorous investigation because they might signal a widespread problem," the researchers emphasize.

Ann Intern Med 2005;142:898-902.