A patient notification exercise following infection control failures in a dental surgery.
OBJECTIVE
To investigate the association between treatment by a dental healthcare worker (HCW) and patient infection with a blood-borne virus (BBV).


METHODS
Nested case control study.


METHODS
A patient notification exercise (PNE) arising from a hepatitis C virus positive HCW that was undertaken because of deficiencies in infection control practice.


METHODS
Cases were individuals with a BBV infection identified as a result of the PNE. Controls were randomly selected individuals with negative tests for BBVs. Detailed information on dental treatment was obtained from patient notes. Information on risk factors for BBV infection was obtained using a structured questionnaire administered by telephone interview.


RESULTS
Thirty patients had evidence of infection with a BBV. The mean number of visits for treatment was 20.5 in cases and 18.6 in controls; the difference 1.8 (95% CI -5.4 to 9.1) was not statistically significant (p = 0.62). Transmission of hepatitis C in the dental setting was excluded by sequencing of the viral genome or establishing alternative risk factors.


CONCLUSIONS
There was no evidence of transmission of hepatitis C virus from the HCW to patients, or transmission of a BBV from patient to patient. To ensure consistent practice within the UK the National Institute for Health and Clinical Excellence should produce guidance on PNEs for the NHS.
Mason
B W
BW
Communicable Disease Surveillance Centre Wales, National Public Health Service for Wales, The Temple of Peace and Health, Cathays Park, Cardiff CF103NW. brendan.mason@nphs.wales.nhs.uk
Cartwright
J
J
Sandham
S
S
Whiteside
C
C
Salmon
R L
RL
D017848:Blood-Borne Pathogens; D016022:Case-Control Studies; D003428:Cross Infection / Q000635:transmission; D003729:Dental Care / Q000145:classification / Q000706:statistics & numerical data; D003815:Dentists; D018563:Disease Notification; D005260:Female; D016679:Genome, Viral / Q000235:genetics; D006678:HIV / Q000145:classification; D016174:Hepacivirus / Q000145:classification / Q000235:genetics; D006515:Hepatitis B virus / Q000145:classification; D006526:Hepatitis C / Q000635:transmission*; D006801:Humans; D019552:Infection Control, Dental; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000706:statistics & numerical data*; D008297:Male; D008403:Mass Screening; D008487:Medical History Taking; D008875:Middle Aged; D018570:Risk Assessment; D013997:Time Factors; D006113:United Kingdom; D014766:Viremia / Q000821:virology