Professional Development

Outbreaks of viral hepatitis linked to poor infection control practices

Last Updated: 2009-01-06 17:50:17 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Viral transmission of hepatitis B (HBV) and hepatitis C (HCV) in outpatient clinics and other nonhospital health care settings is a growing problem that deserves "immediate attention," conclude researchers from the Centers for Disease Control and Prevention in a report in the January 6 issue of Annals of Internal Medicine.

Dr. Nicola Thompson of the Division of Viral Hepatitis at CDC and colleagues identified 33 outbreaks of HBV or HCV in nonhospital health care settings in the past 10 years. Twelve occurred in outpatient clinics, 6 in hemodialysis centers, and 15 in long-term care facilities.

"We believe this is likely to be a minimum estimate of the number of viral hepatitis outbreaks and infections that have occurred in these settings as we face a number of obstacles in identifying these of outbreaks, including limitations of hepatitis surveillance and the fact that a large number of epatitis B and C infections are asymptomatic and go undiagnosed," Dr. Thompson told Reuters Health.

A total of 448 persons acquired HBV or HCV as a result of these 33 outbreaks and "many thousands more were placed at risk for infection unnecessarily," Dr. Thompson and colleagues note in their report.

Breaches of fundamental principles of infection control were responsible for patient-to-patient transmission of hepatitis in all 33 outbreaks, the researchers found.

"We believe the increasing frequency of these outbreaks coincide with the increase in utilization of healthcare in nonhospital settings that traditionally have less oversight and limited infection control resources," Dr. Thompson said.

This analysis, she added, "reminds us that it is critical for all health care providers to understand and follow correct infection control practices. Preventing these outbreaks is the responsibility of every health care worker and represents basic patient safety. All providers are urged to carefully review their infection control practices and the practices of all staff under their supervision."

Ann Intern Med 2009;150:33-39.