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REVIEW Nonhospital Health
Care–Associated Hepatitis B and C Virus
Transmission: United States, 1998–2008
Nicola D. Thompson, PhD, MS; Joseph F. Perz,
DrPH, MA; Anne C. Moorman, BSN, MPH; and Scott
D. Holmberg, MD, MPH
6 January 2009 | Volume 150 Issue 1 |
Pages 33-39
In the United States,
transmission of hepatitis B virus (HBV)
and hepatitis C virus (HCV) from health
care exposures has been considered
uncommon. However, a review of outbreak
information revealed 33 outbreaks in
nonhospital health care settings in
the past decade: 12 in outpatient clinics, 6 in
hemodialysis centers, and 15 in
long-term care facilities, resulting in 448
persons acquiring HBV or HCV infection. In
each setting, the putative mechanism
of infection was patient-to-patient transmission
through failure of health care personnel
to adhere to fundamental principles
of infection control and aseptic technique (for
example, reuse of syringes or lancing
devices).
Difficult to detect and investigate, these
recognized outbreaks indicate a wider
and growing problem as health care is
increasingly provided in outpatient
settings in which infection control training
and oversight may be inadequate. A
comprehensive approach involving
better viral hepatitis surveillance and case
investigation, health care provider
education and training, professional oversight,
licensing, and public awareness is needed
to ensure that patients are always
afforded basic levels of protection against
viral hepatitis transmission.
Author
and Article Information
From the Centers for Disease
Control and Prevention, Atlanta, Georgia.
Potential Financial Conflicts of Interest:
None disclosed.
Requests for Single Reprints: Nicola
D. Thompson, PhD, MS, Division of
Viral Hepatitis, Centers for Disease Control and
Prevention, 1600 Clifton Road, MS
G-37, Atlanta, GA 30333; e-mail,
ndthompson@cdc.gov
.
Current Author Addresses: Drs. Thompson
and Holmberg and Ms. Moorman:
Division of Viral Hepatitis, Centers for Disease
Control and Prevention, 1600 Clifton
Road, MS G-37, Atlanta, GA 30333.
Dr. Perz: Division of Healthcare Quality
Promotion, Centers for Disease
Control and Prevention, 1600 Clifton Road, MS
A-31, Atlanta, GA 30333.
Author Contributions: Conception and
design: N.D. Thompson, J.F. Perz,
S.D. Holmberg.
Analysis and interpretation of the data: N.D.
Thompson, J.F. Perz, A.C. Moorman,
S.D. Holmberg.
Drafting of the article: N.D. Thompson, J.F.
Perz, S.D. Holmberg.
Critical revision of the article for
important intellectual content: N.D.
Thompson, J.F. Perz, A.C. Moorman, S.D.
Holmberg.
Final approval of the article: N.D. Thompson,
J.F. Perz.
Obtaining of funding: S.D. Holmberg.
Administrative, technical, or logistic support:
J.F. Perz, A.C. Moorman, S.D.
Holmberg.
Collection and assembly of data: N.D.
Thompson, J.F. Perz, A.C. Moorman,
S.D. Holmberg.
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