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NEW YORK (Reuters Health) Feb 16 - An outbreak of hepatitis C virus (HCV) infection on an orthopedic ward, with no obvious breach of infection control policies, led investigators to recommend against the use of multidose vials.
As described in the February issue of the Journal of Medical Virology, three patients who were treated on the ward were diagnosed with acute icteric hepatitis C over a 3-month period.
Dr. R. Stefan Ross of Essen University Hospital and the University of Duisburg-Essen, Germany, and colleagues investigated the outbreak by using HCV-PCR to perform HCV sequencing in 135 patients who had stayed in the unit and 104 staff members.
Ultimately, the investigators identified six patients (including the initial three) infected with very closely related HCV variants.
Dr. Ross and colleagues say that "patient-to-patient spread of the virus was inferred to have started from one patient with previous HCV infection to the other five patients during their hospital stay."
However, the team did not uncover any breaches in infection control practices or any specific activity that might have led to nosocomial transmission.
Nonetheless, "As a result of the investigations, the hospital corrected the documentation of all medical and nursing activities undertaken in the ward, abandoned the use of all multidose saline and other medication vials, and included explicitly recommendations for the safe preparation and administration of injectable drugs into internal infection control guidelines," Dr. Ross and colleagues explain.
Thereafter, "no further nosocomial transmissions of HCV have been recorded in the orthopedic ward."
The investigators comment that this episode shows that nosocomial HCV transmission is not limited to hemodialysis, hematology or oncology settings.
J Med Virol 2009;81:249-257.
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