A cluster of hepatitis C virus infections associated with ozone-enriched transfusion of autologous blood in Rome, Italy.
OBJECTIVE
To describe an outbreak of hepatitis C virus (HCV).


METHODS
Retrospective cohort study.


METHODS
Outpatient department of a hospital in Rome, Italy.


METHODS
All 42 patients exposed to ozone therapy by autohemotherapy or intramuscular injection from January to June 2001.


METHODS
Epidemiologic investigation, serologic analysis, and virus genotyping.


RESULTS
Thirty-one (74%) of the patients agreed to participate in the study. Three (9.7%) had symptoms of HCV infection. This incidence rate was higher than the rate of 1.4 per 100,000 per year in the regional population. Six patients were positive for HCV antibodies and HCV RNA for a prevalence rate of 19.4%, which was much higher than the estimate of 0.9% in the population. Virus genotype 1b was found in two case-patients (one symptomatic) and 2c in four case-patients (two symptomatic), one of whom was known to have an HCV infection since 1986 and could have been the source of infection. The infected patients were all being exposed to ozone-enriched transfusions of autologous blood. Although the specific mode of transmission between patients was not detected, transmission probably occurred during one of the three busiest therapeutic sessions in the 6-month period.


CONCLUSIONS
Transmission of HCV infection may occur during medical procedures with limited bleeding. Standard precautions must be applied in any healthcare setting; restricting the number of individuals treated during each therapeutic session could be an effective way of avoiding accidental transmission of infection.
Faustini
Annunziata
A
Department of Epidemiology, Local Health Authority RM-E, via Santa Costanza n. 53, 00198 Rome, Italy. faustini@asplazio.it
Capobianchi
Maria R
MR
Martinelli
Mauro
M
Abbate
Isabella
I
Cappiello
Giuseppina
G
Perucci
Carlo A
CA
D000328:Adult; D000368:Aged; D001804:Blood Transfusion, Autologous; D003428:Cross Infection / Q000453:epidemiology*; D004196:Disease Outbreaks; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010126:Ozone / Q000627:therapeutic use*; D015995:Prevalence; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D012384:Rome / Q000453:epidemiology
D012367:RNA, Viral; D010126:Ozone