Outbreak of hepatitis C virus infections originating from a breach in safe injection practices before contrast-enhanced computed tomography scanning - 31/10/20

Doi : 10.1016/j.jhin.2020.05.041

C. Balmelli ^a,^⁎ , G. Merlani ^b, G. Martinetti ^a, D. Reinholz ^b,^⁎ , S. Paolucci ^c, F. Baldanti ^d, A. Piralla ^c,^d, F. Del Grande ^e, E. Bernasconi ^f
^a Division of Infection Control and Hospital Epidemiology, Ente Ospedaliero Cantonale, Bellinzona, Ticino, Switzerland
^b Division of Public Health, Canton Ticino, Bellinzona, Ticino, Switzerland
^c Fondazione IRCCS Policlinico San Matteo, Pavia, Lombardy, Italy
^d University of Pavia, Pavia, Lombardy, Italy
^e Clinica di Radiologia EOC, Istituto di Imaging della Svizzera Italiana, Ospedale Regionale di Lugano, Ticino, Switzerland
^f Division of Infectious Diseases, Ospedale Regionale di Lugano, Lugano, Ticino, Switzerland

^∗Corresponding author. Address: Division of Infection Control and Hospital Epidemiology, Ente Ospedaliero Cantonale, Bellinzona, Ticino, Switzerland. Tel.: + 41 91 811 6580; fax: +41 91 811 6130.Ospedale Regionale di LuganoVia Tesserete 46Lugano6903Switzerland^†Current address: Gesunheitsdepartement, Kantonsarztamt, St. Gallen, Switzerland.Gesunheitsdepartement, KantonsarztamtEnte Ospedaliero CantonaleSt. GallenSwitzerland

Summary

Four patients who underwent contrast-enhanced computed tomography (CT) scanning were infected with hepatitis C virus from a contaminated multi-dose vial of NaCl. The outbreak likely occurred due to a breach in safe injection practices, resulting in contamination of the vial. Not all patients exposed to the same vial were infected. The uneven distribution of infections could be attributed to a stochastic effect of a low infectious dose. This implies that outbreak investigations need to be extended to all patients scheduled before and after the first identified infected patient to confirm or rule out nosocomial transmission.

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Keywords : Cross-infections, Hepatitis C, Outbreak, Nosocomial transmission, Safe injection practices, Tomography

Plan

Patient investigation

Molecular analysis

Analysis of critical points as cause of outbreak

Identification of the carrier

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Vol 106 - N° 3

P. 600-604 - novembre 2020 Retour au numéro

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Outbreak of hepatitis C virus infections originating from a breach in safe injection practices before contrast-enhanced computed tomography scanning - 31/10/20

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