A team from the Centers for Disease Control report today in the Annals of Internal Medicine that, in the past 10 years, infection control has failed so significantly that 448 people have become infected with hepatitis B or C and more than 60,000 had to be tested for potential infection. (And that is almost certainly an underestimate, since the team counted only previously recognized outbreaks of two or more infections, not single ones.)
Three are known to have died, though that again is probably an underestimate.
From the CDC press release (not yet online, I'll link when it is):
In the United States, transmission of HBV and HCV while receiving health care has been considered uncommon. However, a review of CDC outbreak information revealed a total of 33 identified outbreaks outside of hospitals in 15 states, during the past decade: 12 in outpatient clinics, six in hemodialysis centers and 15 in long-term care facilities.Here are some of the actions that caused these infections:
- reusing syringes
- contaminating multi-dose vials with unclean syringes
- using single-dose vials for multiple patients
- re-using end-caps from single-use syringes
- using fingerstick devices on multiple patients without cleaning
- using blood-sugar measuring devices on multiple patients without cleaning
And, infuriatingly, there are probably many more such infections that remain undetected. From the paper:
...the viral hepatitis outbreaks reported here probably represent only a portion of the true burden of infection attributable to the receipt of health care in the United States. First, we included only nonhospital health care settings. ... Second, under-ascertainment of health care–associated viral hepatitis outbreaks is likely. Linking an outbreak to a single health care venue responsible for transmission is complicated by the long incubation period of HCV and HBV infection (up to 6 months)... Furthermore, many patients with HBV or HCV infection will be asymptomatic or have mild or nonspecific symptoms, resulting in infections that go undetected for many years. Finally, outbreak detection relies on thorough case investigation and successful identification of health care as a risk. Few health departments currently have the time, funds, personnel resources, or ability to address legal impediments to investigate viral hepatitis that may be health care–associated.The cite is: Nicola D. Thompson, PhD, MS; Joseph F. Perz, DrPH, MA; Anne C. Moorman, BSN, MPH; and Scott D. Holmberg, MD, MPH. Nonhospital Health Care–Associated Hepatitis B and C Virus Transmission: United States, 1998–2008. Ann Intern Med. 2009;150:33-39.
My name is John Wilpers. I am the Global Blog Coordinator for GlobalPost, a new international news organization set to launch on Jan. 12 (see www.globalpost.com).
My job is to build a list of blogs that will appear on GlobalPost where we will have approximately 65 correspondents in some 46 countries plus high-profile correspondents writing about major themes we’re calling Latitudes (Commerce, Diplomacy, Environment, Health, NGOs, Sports, Technology, Wheels).
We are looking for enlightening, informative posts from bloggers writing (in English) about those themes. And we were very pleased and excited to find your blog about Health.
So, I would like to extend an invitation to you to have the most recent post of Superbug included on the Health page of GlobalPost.com as part of our “Global Blogs” service. (I also e-mailed you to double the chances of reaching you before we launch next week. Please pardon my enthusiasm for getting your posts onto GlobalPost.com!)
After reviewing thousands of blogs worldwide, we have found Superbug to be one that is thought provoking and gives readers your unique perspective on the issues and events in the world of Health.
The way it would work if you accept our invitation is that we would use your RSS feed to place your most recent post on your personal page on GlobalPost.com. We would point back to your actual blog for comments and for archives, hopefully driving lots of traffic to your site. Each time you write a new post, it would replace the older one so only one post would appear on GlobalPost.com.
By appearing on Global Post’s exciting new international news website, your words, viewpoints, and pictures would gain worldwide exposure. Your posts would not only appear instantly on globalpost.com but also possibly on the sites of our partners, including the Huffington Post (7.8 million U.S. and 9.7 million global monthly unique visitors) and other news and information websites.
You don’t need to do anything differently. We do request that you consider pointing back to us from your blog (we will send out logos shortly for your consideration), but that’s not a requirement.
You should know that we have a few guidelines that we observe here at Global Post:
1) We do not publish racist, sexist, or misogynist comments (unless those comments are the subject of the post).
2) We do not publish obscene language or photos. While we recognize that obscenity can be difficult to define, we know it when we see it and we will let you know if we think you have crossed our line.
3) We do not permit plagiarism. Any work taken from another source must be attributed to that source.
4) We do not publish libelous or slanderous language.
5) We do not tolerate repeated errors of fact or misrepresentations of facts or quotes.
6) We do not publish work inciting violence.
Failure to observe these guidelines would result in the removal of your blog from GlobalPost. We would contact you, of course, to discuss the post in question.
Because we have a broad multicultural audience holding every conceivable political and religious viewpoint, we want to respect their views while also possibly challenging them. We will host controversial work. We will encourage robust debate of the hottest topics. We will not stifle discussion, only abuse of people, belief systems, and laws.
We hope these guidelines are acceptable to you.
I look forward getting your permission to put your RSS feed on our site. Please reply to: firstname.lastname@example.org. Thank you!
PS If you choose to accept our invitation and would like a photo and a short biography to appear on GlobalPost, please send both to me with your confirmation e-mail or at some time shortly thereafter.
Global Blog Coordinator
The Pilot House
Boston, MA 02110
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