Failures To Follow Infection Practices Increases Patient's Hepatitis B, C Risk


A new study by the Center for Disease Control and Protection (CDC) in the Annuals of Internal Medicine (Jan 6, 2009) notes that in the last decade, more than 60,000 patients in the United States were asked to get tested for hepatitis B virus (HBV) and hepatitis C virus (HCV) because health care personnel in settings outside hospitals failed to follow basic infection control practices.

Dr John Ward, director of CDC's Division of Viral Hepatitis, says "This report is a wake-up call. Thousands of patients are needlessly exposed to viral hepatitis and other preventable diseases in the very places where they should feel protected. No patient should go to their doctor for health care only to leave with a life-threatening disease."

In the United States, it has been considered uncommon to have transmission of HBV and HCV while receiving health. However, this review of CDC outbreak information revealed a total of 33 identified outbreaks outside of hospitals in 15 states, during the past decade. This included 12 in outpatient clinics, six in hemodialysis centers and 15 in long-term care facilities, resulting in 450 people acquiring HBV or HCV infection.

The exposure of patients to these potentially deadly diseases occurred because health care personnel failed to follow basic infection control procedures and aseptic technique in injection safety. Common factors identified in these outbreaks were reuse of syringes and blood-contamination of medications, equipment and devices.

The report shows the need for ongoing professional education for health care providers. It is also important to have consistent state oversight in detecting and preventing the transmission of bloodborne pathogens in health care settings.

CDC assists local health departments by providing routine surveillance, outbreak investigation support, field personnel and lab expertise.

CDC and its partners are working to address this important patient safety problem through a number of efforts, including:


* Improving viral hepatitis surveillance, case investigation and outbreak response, such as support for health departments to thoroughly investigate all individuals identified to have HBV or HCV infection;

* Strengthening the capacity of state and local viral hepatitis prevention programs;

* Augmenting the CDC′s National Healthcare Safety Network, the national surveillance system for tracking health care-associated infections, to collect outpatient setting information;

* Partnering with the Hepatitis Outbreaks′ National Organization for Reform (HONOReform), a patient advocacy foundation, to create patient and provider education materials;
* Continued improvement of injection safety practices through educational outreach efforts with professional nursing and anesthesiology organizations;

* Working with partners in the dialysis, diabetes and long-term care communities to promote safe care practices;

* Working with regulators and professional societies to strengthen licensure and accreditation processes with emphasis on safe injection practices;

* Exploring ways to improve curricula in nursing and medical schools related to safe health care practices.

For more information on preventing viral hepatitis in health care settings, visit the CDC website.

Annuals of Internal Medicine, Jan 2009
Center for Disease Control and Protection (CDC)