Large Outbreak of Hepatitis C Virus Associated With Drug Diversion by a Healthcare Technician

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Sharon Alroy-PreisNew Hampshire and Centers for Disease Control and Prevention Investigation Teams

Abstract

In May 2012, the New Hampshire (NH) Division of Public Health Services (DPHS) was notified of 4 persons with newly diagnosed hepatitis C virus (HCV) infection at hospital X. Initial investigation suggested a common link to the hospital cardiac catheterization laboratory (CCL) because the infected persons included 3 CCL patients and a CCL technician. NH DPHS initiated an investigation to determine the source and control the outbreak. NH DPHS conducted site visits, case patient and employee interviews, medical record and medication use review, and employee and patient HCV testing using enzyme immunoassay for anti-HCV, reverse-transcription polymerase chain reaction for HCV RNA, nonstructural 5B (NS5B) and hypervariable region 1 (HVR1) sequencing, and quasispecies analysis. HCV HVR1 analysis of the first 4 cases confirmed a common source of infection. HCV testing identified 32 of 1074 CCL patients infected with the outbreak strain, including 3 patients coinfected with >1 HCV strain. The epidemiologic investigation revealed evidence of drug diversion by the HCV-infected technician, evidenced by gaps in controlled medication control, higher fentanyl use during procedures for confirmed cases, and building card key access records docu...Continue Reading

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Citations

Jun 23, 2020·Briefings in Bioinformatics·Sergey KnyazevAlexander Zelikovsky
Oct 28, 2020·Vox Sanguinis·Veronica C HoadIain B Gosbell
Mar 2, 2021·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Stacy R TresslerDanae Bixler
May 13, 2021·European Journal of Hospital Pharmacy. Science and Practice·Valentina LichtnerBryony Dean Franklin

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