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Ann Intern Med. 1999 Jan 19;130(2):130-4.

Epidemiologic and molecular investigation of outbreaks of hepatitis C virus infection on a pediatric oncology service.

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  • 1University Hospital and the Regional Center for Communicable Disease Control, Malmö, Sweden.

Abstract

BACKGROUND:

Despite screening of blood donors, hepatitis C virus (HCV) infection can occur in patients who receive multiple transfusions.

OBJECTIVE:

To clarify mechanisms of nosocomial transmission of HCV.

DESIGN:

Epidemiologic and molecular analyses of hepatitis C outbreaks.

SETTING:

Pediatric oncology ward.

PATIENTS:

Children with cancer.

MEASUREMENTS:

Epidemiologic analysis, HCV RNA detection, genotyping, and hypervariable region 1 (HVR1) sequencing.

RESULTS:

Ten cases of infection with acute HCV genotype 3a occurred between 1990 and 1993. Sequencing of HVR1 revealed three related strains. Despite an overhaul of hygiene procedures, a patient infected with genotype 1b generated nine subsequent infected patients in 1994. Several patients had high virus titers and strongly delayed anti-HCV antibody responses. All had permanent intravenous catheters. Multidose vials used for flushing or treatment had probably been contaminated during periods of overlapping treatment.

CONCLUSIONS:

Contamination of multidose vials was the most likely mode of HCV transmission; therefore, use of such vials should be restricted. Rigorous adherence to hygiene routines remains essential to preventing transmission of bloodborne infections.

PMID:
10068359
[PubMed - indexed for MEDLINE]
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