ATLANTA—While transmission of the hepatitis B (HBV) and hepatitis C (HCV) viruses in healthcare settings is considered rare, recent reports of outbreaks indicate a growing problem, according to a recent report by the Centers for Disease Control and Prevention.
“Difficult to detect and investigate, these recognized outbreaks indicate a wider and growing problem as healthcare is increasingly provided in outpatient settings in which infection control training and oversight may be inadequate,” the authors wrote.
Over the past decade, there have been 33 outbreaks in non-hospital healthcare settings in the United States. Twelve were in outpatient clinics, 6 in dialysis centers and 15 in long-term care facilities. These outbreaks have resulted in 448 people acquiring HBV or HCV infection, and thousands more being placed at risk, according to the CDC report, which appeared in the Jan. 6 issue of the Annals of Internal Medicine.
Researchers looked at the circumstances surrounding these outbreaks to determine how healthcare exposure and practices contributed to transmission. In all cases, patient-to-patient transmission resulted from lapses in basic infection control practices, such as reuse of syringes or lancing devices, among non-hospital healthcare personnel.
According to researchers, healthcare is increasingly provided in outpatient settings in which infection control training and oversight may be inadequate. Nonetheless, viral hepatitis outbreaks are preventable, and healthcare should provide no opportunity for transmission.
The researchers suggested that a comprehensive preventive approach that includes augmented viral hepatitis surveillance, healthcare provider education, training in appropriate infection control practices and techniques, improved oversight, and more uniform regulation could help prevent future outbreaks.
