SOURCES: Barbara Montana, M.D., M.P.H., medical director, communicable disease service, New Jersey Department of Health; Gwen Borlaug, M.P.H., coordinator, HAI Prevention Program, Wisconsin Division of Public Health, Madison, Wisc.; Marc Siegel, M.D., professor, medicine, NYU Langone Medical Center, New York City; Feb. 27, 2015, Morbidity and Mortality Weekly Report
FRIDAY, Feb. 27, 2015 (HealthDay News) -- Two cases of hepatitis C infection that occurred during routine surgeries highlight the need for hospitals to tighten infection control to prevent more transmissions, officials said Friday.
In one case, two New Jersey patients (one of them had hepatitis C) received an injection of the anesthetic propofol from the same medication cart. In the other instance, two Wisconsin patients (one of them had hepatitis C) received kidneys that had been prepared for transplantation on the same machine, according to an article in the Feb. 27 issue of Morbidity and Mortality Weekly Report, a publication of the U.S. Centers for Disease Control and Prevention.
The source of the infection in the Wisconsin case was not pinpointed, said Gwen Borlaug, coordinator of the HAI Prevention Program at the Wisconsin Division of Public Health, but "we identified breaches in infection control practices in the operating room that likely resulted in the transmission."
In the New Jersey case, the infection was traced to contaminated equipment that was taken from one operating room to another. Dr. Barbara Montana, medical director of the communicable disease service at the New Jersey Department of Health, said, "Fortunately, these infections can be prevented when health care providers follow basic infection prevention practices."
According to the CDC, 22 outbreaks of health-care-associated hepatitis infections occurred from 2008 through 2014. Most of the outbreaks occurred in outpatient care centers and long-term care facilities.
These outbreaks typically involved unsafe injection practices, such as using medication vials on multiple patients or reusing needles or syringes, Borlaug said. Other outbreaks have occurred as a result of contaminated items, such as blood sugar testing devices, she said.
"It is imperative to always practice sound infection control measures, such as cleaning and disinfecting used medical equipment and patient care items, and observing safe injection practices," Borlaug said.
Patients can also play a part in preventing these infections, Montana said.
"Patients should ask questions about infection prevention practices, such as whether health care providers are following good infection prevention practices, including hand washing and using a new needle/syringe for each patient and cleaning equipment between patients," she said.
Hepatitis C is a virus that attacks the liver. In its chronic form, it affects some 3.2 million Americans, according to the CDC. However, about 75 percent to 85 percent of those with chronic hepatitis C eventually develop acute disease, which can result in serious liver damage and liver cancer.
Hepatitis C is a leading cause of liver cancer and the need for liver transplantation, according to the agency.
Unlike its cousins hepatitis A and B, which can be prevented with a vaccine, there is no vaccine for hepatitis C. However, it can be treated.
Until widespread screening of the blood supply began in 1992 in the United States, there was no screening test for the virus. For that reason, the CDC recommends that anyone born between 1945 and 1965 get tested for hepatitis C.
Dr. Marc Siegel, a professor of medicine at NYU Langone Medical Center in New York City, said these cases are likely only the tip of the iceberg and many more such infections occur in hospitals.
"These two cases are reminders of the small amount of hepatitis C virus that is necessary to cause infection and the importance of proper sterilization and handling of all dental and medical equipment at all times, especially amid a national epidemic of viral hepatitis with no vaccine for hepatitis C," he said.
Visit the U.S. Centers for Disease Control and Prevention for more on hepatitis C.