Nosocomial transmission of hepatitis C virus associated with the use of multidose saline vials.
OBJECTIVE
To identify the source of an outbreak of acute hepatitis C virus (HCV) infection among 3 patients occurring within 8 weeks of hospitalization in the same ward of a Florida hospital during November 1998.


METHODS
A retrospective cohort study was conducted among 41 patients hospitalized between November 11 and 19, 1998. Patients' blood was tested for antibodies to HCV, and HCV RNA-positive samples were genotyped and sequenced.


RESULTS
Of the 41 patients, 24 (59%) participated in the study. HCV genotype lb infections were found in 5 patients. Three of 4 patients who received saline flushes from a multidose saline vial on November 16 had acute HCV infection, whereas none of the 9 patients who did not receive saline flushes had HCV infection (P = .01). No other significant exposures were identified. The HCV sequence was available for 1 case of acute HCV and differed by a single nucleotide (0.3%) from that of the indeterminate case.


CONCLUSIONS
This outbreak of HCV probably occurred when a multidose saline vial was contaminated with blood from an HCV-infected patient Hospitals should emphasize adherence to standard procedures to prevent blood-borne infections. In addition, the use of single-dose vials or prefilled saline syringes might further reduce the risk for nosocomial transmission of blood-borne pathogens.
Krause
Gérard
G
Epidemic Intelligence Service, State Branch, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Trepka
Mary Jo
MJ
Whisenhunt
Robert S
RS
Katz
Dolly
D
Nainan
Omana
O
Wiersma
Steven T
ST
Hopkins
Richard S
RS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017848:Blood-Borne Pathogens; D002408:Catheters, Indwelling / Q000821:virology; D002648:Child; D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology / Q000821:virology*; D004196:Disease Outbreaks; D004866:Equipment Contamination; D005260:Female; D005431:Florida; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics* / Q000302:isolation & purification; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D018937:Hepatitis C Antibodies / Q000097:blood; D006757:Hospital Units / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012965:Sodium Chloride; D013594:Syringes / Q000821:virology*
D018937:Hepatitis C Antibodies; D012367:RNA, Viral; D012965:Sodium Chloride