(CHRISTIANSBURG, Va.) – The New River Valley has elevated rates of acute hepatitis C, and numbers are increasing every year.
Antonio Brown Jr., a public health associate from the Centers for Disease Control and Prevention (CDC), works to prevent hepatitis C transmission in the New River Valley. During his two-year fellowship with the New River Health District Academic Health Department and Virginia Tech he will develop a comprehensive hepatitis C prevention plan. His work includes conducting interviews, identifying and investigating new cases and providing prevention education.
“Since 2012, more than 1,000 cases of hepatitis C have been reported in the New River Health District,” said District Health Director Noelle Bissell, M.D. “We have seen significant numbers of cases of acute hepatitis C infection linked to tattoo parlors, the use of homemade tattoo guns at parties and in people who report more than 10 sex partners. We’re also noticing a trend in cases associated with intravenous drug abuse, particularly methamphetamine, and in pregnant women and women of childbearing age.”
Trinity Health and its hospital in Minot have agreed in principal on a legal settlement with 21 victims of the largest hepatitis C outbreak in recent U.S. history
BISMARCK, N.D. (AP) — Trinity Health and its hospital in Minot have agreed in principal on a legal settlement with 21 victims of the largest hepatitis C outbreak in recent U.S. history, though Trinity’s legal fight with a nursing home where most people were sickened will continue.
Trinity attorneys filed a request asking state Judge Todd Cresap to dismiss the lawsuit, saying Trinity recently reached a confidential settlement resolving the plaintiffs’ claims. They asked Cresap to allow a connected legal dispute between the hospital and the former ManorCare nursing home to be resolved in federal court, where it originated. Cresap has not yet ruled.
Notes from the Field: Hepatitis C Outbreak in a Dialysis Clinic — Tennessee, 2014 Weekly – January 1, 2016 Outbreaks of hepatitis C virus (HCV) infections can occur among hemodialysis patients when recommended infection control practices are not followed (1). On January 30, 2014, a dialysis clinic in Tennessee identified acute HCV in a patient (patient A) during routine screening and reported it to the Tennessee Department of Health. Patient A had enrolled in the dialysis clinic in March 2010 and had annually tested negative for HCV (including a last HCV test on December 19, 2012), until testing positive for HCV antibodies (anti-HCV) on December 18, 2013 (confirmed by a positive HCV nucleic acid amplification test). Patient A reported no behavioral risk factors, but did have multiple health care exposures.
On April 16, 2014, the Tennessee Department of Health observed infection control practices at the clinic. Clinic officials reported that no changes to infection control protocols at the dialysis clinic had been made from the time patient A was identified to this date of observation. The health department observers noted that no visible blood was present on any surfaces, sinks were easily accessible, staff hand hygiene was performed consistently, and gloves and other personal protective equipment were used appropriately. Individual patient stations were disinfected after the previous patient left the station, with a 1:100 diluted household bleach solution, and surfaces were allowed to dry completely between patients. Medications were prepared for each patient in a separate, clean medication room at the time of administration; no multidose medication vials were carried into patient care areas. Blood for glucose testing was drawn from dialysis access sites with a syringe and tested by a glucometer in the laboratory. The glucometer was adequately disinfected between uses. Monthly trainings in infection control had been consistently provided to all staff members before the outbreak was identified.
Sixty-two dialysis patients were being treated at the clinic at the time of the investigation; all were retested for HCV. Nine (15%) patients, including patient A, were HCV-infected; specimens from patient A and five other chronically infected dialysis patients were positive for HCV genotype 1a (Figure), the remaining three were positive for genotype 1b. Genotype 1a is the most prevalent genotype in the United States (2). Patient B, who seroconverted in December 2010, had a history of injection drug use, which, at the time of diagnosis, was considered to be the source of exposure. Patient C was chronically infected and had tested positive for HCV upon admission at the dialysis clinic. Infection duration for all other HCV infected patients, including patient C, was unknown. Quasispecies (HCV intra-genotype variants) analysis was performed from serum specimens collected from all nine patients found to be HCV positive. Patients A, B, and C were infected with genotype 1a; less than 5% nucleotide variation among intra-host HCV sequences was detected among the three patients, suggesting epidemiologic linkage of these infections (Figure). On separate occasions, patients A and B underwent dialysis on the same machine following patient C, during the most likely exposure periods (January–May 2013 for patient A and November 2009–June 2010 for patient B). Hospitalization events for patients A, B, and C during the likely exposure periods did not overlap in space and time. No other common exposures were identified.