Published Date: 2010-11-13 18:00:04
Subject: PRO/EDR> Hepatitis B, nosocomial, care home - USA: (NC)
Archive Number: 20101113.4129
HEPATITIS B, NOSOCOMIAL, CARE HOME - USA: (NORTH CAROLINA)
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Date: Fri 12 Nov 2010
Source: WRAL.com [edited]
<http://www.wral.com/news/local/story/8616189/>
Unsafe practices likely spread hepatitis at assisted living center
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State public health officials on Friday [12 Nov 2010] said a fatal
hepatitis B outbreak at a Wayne County assisted living center probably
occurred when staff used the same blood-glucose monitors on different
residents. 5 residents of Glen Care of Mount Olive who have died since
August 2010 had hepatitis, while 3 other residents contracted the disease
but survived, according to state officials. The deceased ranged in age from
63 to 83.
Investigators with the Division of Public Health said all 8 underwent
blood-glucose monitoring at the center, and residents who have diabetes
were 15 times more likely to be involved in the outbreak than other
residents. The investigators said Glen Care staff sometimes stored glucose
monitors together and didn't label them with residents' names. The devices
also weren't disinfected after each use, according to investigators.
"If you get contamination that isn't even visible on the glucometer, that
can get on the glove (or) get on the lancing device (and) then be
introduced in the person," said Dr Megan Davies, North Carolina's state
epidemiologist.
Hepatitis B virus is a virus that can cause severe liver problems, and it
is typically transmitted by exposure to blood or body fluids. Symptoms
include fever, extreme fatigue, loss of appetite, vomiting, dark urine and
yellowish skin. The state recommended that Glen Care store glucose meters
in residents' rooms, disinfect them after each use, and switch to
single-use needles for these devices.
Glen Care officials said on Thursday [11 Nov 2010] that the center's staff
weren't responsible for the hepatitis outbreak. Medical technicians said
they had never used glucose monitors on different patients. "I don't
believe these loving, caring people shared the same pen on different
patients," said Anne Kornegay, vice president of Kornegay Healthcare, which
owns the assisted living center. Kornegay suggested the outbreak was caused
by people coming in from outside or by residents sharing drinks or having sex.
State investigators said they couldn't determine the source of the
outbreak, noting the center is open to relatives and other visitors and
that residents are free to come and go. Davies called the situation tragic
and said Glen Care needs to strengthen its infection-control practices.
The state Division of Health Service Regulation has already issued a
6-point corrective plan to Glen Care for infection control. By Fri 19 Nov
2010, the facility must appoint a staff member to coordinate
infection-control measures at the facility, provide staff training on
proper procedures and have a registered nurse or pharmacist observe
blood-glucose monitoring of patients at least once a week.
Glen Care officials said they already have infection-control measures in
place, but in response to the state's corrective plan, they said they now
wash their medical instruments with a bleach solution instead of just soap
and water.
All residents at the center were tested for hepatitis B in October [2010],
health officials said, and 27 people who weren't immune to the virus were
vaccinated. A separate state investigation will determine how Glen Care
will be penalized. Based on preliminary findings, the center could be fined
between USD 1000 and USD 20 000 for each violation.
[byline: Bruce Mildwurf]
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communicated by:
Zach Lutwick
Social Worker
<zach.lutwick@gmail.com>
[Nosocomial hepatitis B infections have occurred repeatedly as a result of
lapses in infection control procedures, often accompanied by transmission
of hepatitis C virus and human immunodeficiency virus. Transmission of
infection during the course of routine monitoring of blood glucose levels
has not been recorded previously to my knowledge. The high proportion of
fatalities among those infected by this route is surprising.
The location of Wayne County, North Carolina, is displayed in the map at
<http://en.wikipedia.org/wiki/Wayne_County,_North_Carolina>. The
HealthMap/ProMED-mail interactive map of the United States can be accessed
at <http://healthmap.org/r/01bw>. - Mod.CP]
See Also
Hepatitis B & C, nosocomial, dental clinic - USA: (MO), RFI 20100803.26142009
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Hepatitis B & C, HIV, nosocomial - Australia: (QL) alert, corr. 20091117.3974
Hepatitis B & C, HIV, nosocomial - Australia: (QL) alert, corr. 20091117.3973
Hepatitis B & C, HIV, nosocomial - Australia: (QL) alert 20091117.3967
Hepatitis B & C, HIV, nosocomial - USA: (FL) alert 20091007.3473
2008
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Hepatitis B & C, HIV, nosocomial (05): USA (NV) 20081210.3882
Hepatitis B & C, HIV, nosocomial (04): USA (NV) 20080928.3073
Hepatitis B & C, HIV, nosocomial (03): USA (NV) 20080302.0854
Hepatitis B & C, HIV, nosocomial (02): USA (NV) 20080228.0809
Hepatitis B & C, HIV, nosocomial - USA: (NV), alert, RFI 20080228.0802
...................cp/ejp/sh
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