title: Five hepatitis B outbreaks in care homes in the UK associated with deficiencies in infection control practice in blood glucose monitoring.
abstract: Healthcare-associated hepatitis B virus (HBV) outbreaks have been reported in the USA and from several countries in Europe. Patient-to-patient transmission of HBV in these settings has been linked to several different types of exposure but one of the most common exposures implicated is the use of 'finger-stick' lancet devices for blood glucose testing. This article is an account of the investigations into a series of HBV outbreaks linked to the use of lancing devices in community healthcare settings in the UK. Between February 2004 and December 2006, nine individuals with acute HBV infection were reported to five local units of the Health Protection Agency. Investigations identified a further 12 individuals with HBV infection in residents in these settings. The epidemiological and environmental evidence suggests that HBV transmission occurred mostly from a significant breakdown in infection control measures in blood glucose testing. The occurrence of these outbreaks has highlighted the confusion that exists and the need for clear recommendations regarding the use of such devices in the UK.
authors.affiliation: Greater Manchester Health Protection Unit, Manchester, UK. erika.duffell@hpa.org.uk
authors.forename: E F
authors.initials: EF
authors.lastname: Duffell
authors.forename: L M
authors.initials: LM
authors.lastname: Milne
authors.forename: C
authors.initials: C
authors.lastname: Seng
authors.forename: Y
authors.initials: Y
authors.lastname: Young
authors.forename: S
authors.initials: S
authors.lastname: Xavier
authors.forename: S
authors.initials: S
authors.lastname: King
authors.forename: H
authors.initials: H
authors.lastname: Shukla
authors.forename: S
authors.initials: S
authors.lastname: Ijaz
authors.forename: M
authors.initials: M
authors.lastname: Ramsay
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis*; D003428:Cross Infection / Q000453:epidemiology*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D004196:Disease Outbreaks; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000302:isolation & purification; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D001786:Blood Glucose; D006514:Hepatitis B Surface Antigens