Outbreak of Hepatitis B and Hepatitis C Virus Infections Associated with a Cardiology Clinic, West Virginia, 2012–2014

Details

• Alternative Title:
  Infect Control Hosp Epidemiol
• Personal Author:
  Tressler, Stacy ; del Rosario, Maria ; Kirby, Michelle D. ; Simmons, Ashley N. ; Scott, Melissa A. ; Ibrahim, Sherif ; Forbi, Joseph C. ; Thai, Hong ; Xia, Guoliang ; Lyman, Meghan ; Collier, Melissa G. ; Patel, Priti R. ; Bixler, Danae
• Description:
  Objective
  
  To stop transmission of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in association with myocardial perfusion imaging (MPI) at a cardiology clinic.
  
  Design
  
  Outbreak investigation and quasispecies analysis of HCV hypervariable region 1 genome.
  
  Setting
  
  Outpatient cardiology clinic.
  
  Patients
  
  Patients undergoing MPI.
  
  Methods
  
  Case patients met definitions for HBV or HCV infection. Cases were identified through surveillance registry crossmatch against clinic records and serological screening. Observations of clinic practices were performed.
  
  Results
  
  During 2012–2014, seven cases of hepatitis C and four cases of hepatitis B occurred in four distinct clusters among patients at a cardiology clinic. Among three case-patients with HCV infection who had MPI on 6/25/2014, two had 98.48% genetic identity of HCV RNA. Among four case-patients with HCV infection who had MPI on 3/13/2014, three had 96.96% molecular identity of HCV RNA. Two clusters of two patients each with HBV infection had MPI on 3/7/2012 and 12/4/2014. Clinic staff re-used saline vials for more than one patient. No infection control breaches were identified at the compounding pharmacy that supplied the clinic. Patients seen in clinic through 3/27/2015 were encouraged to seek testing for HBV, HCV and human immunodeficiency virus. The clinic switched to all single-dose medications and single-use intravenous flushes on 3/27/2015 and no further cases were identified.
  
  Conclusions
  
  This prolonged healthcare associated outbreak of hepatitis B and hepatitis C was most likely related to breaches in injection safety. Providers should follow injection safety guidelines in all practice settings.
  
  
• Subjects:
  Article Cardiology Cross Infection Disease Outbreaks Hepacivirus Hepatitis B Hepatitis B Virus Hepatitis C Humans West Virginia
• Source:
  Infect Control Hosp Epidemiol. 42(12):1458-1463
• Pubmed ID:
  33641684
• Pubmed Central ID:
  PMC9017790
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  42
• Issue:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:b6f2af7d4f6eb659e005d1e3b7c3f688441dddc81c3c4f6e8e6a38520b8178b9
• Download URL:
  https://stacks.cdc.gov/view/cdc/116495/cdc_116495_DS1.pdf
• File Type:
  [PDF - 634.39 KB ]