In the United States, transmission of Hepatitis B virus and Hepatitis C virus 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.
Dr Nicola Thompson and colleagues from Georgia, USA found 12 outbreaks in outpatient clinics, 6 in hemodialysis centers, and 15 in long-term care facilities, resulting in 448 persons acquiring Hepatitis B or C 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.
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.
Dr Thompson’s team concludes, “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.”