Alexandre Macedo de Oliveira, MD, MSc; Kathryn L. White, RN, BSN; Dennis P. Leschinsky, BS; Brady D. Beecham, BS; Tara M. Vogt, PhD; Ronald L. Moolenaar, MD, MPH; Joseph F. Perz, DrPH; Thomas J. Safranek, MD
Acknowledgments: The authors thank Janel Dockter, BS, and Cristina Giachetti, PhD, for their assistance in nucleic acid testing; Brett Foley, MS, for statistical support; Anne Mardis, MD, MPH, Beth Bell, MD, MPH, and Miriam Alter, PhD, MPH, for critical review of the manuscript; Alice Fournell, for logistic coordination; and Andrew Stuart and Erica Hamilton for data entry. They also thank Thomas McKnight, MD; Jean Schafersman, RN; the testing clinic staff; and most of all the clinic patients for special help in conducting this investigation.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Alexandre Macedo de Oliveira, MD, MSc, Centers for Disease Control and Prevention, 4770 Buford Highway, MS F-22, Atlanta, GA 30341; e-mail, email@example.com.
Current Author Addresses: Dr. Macedo de Oliveira: Centers for Disease Control and Prevention, 4770 Buford Highway, MS F-22, Atlanta, GA 30341.
Mrs. White, Mr. Leschinsky, Ms. Beecham, and Dr. Safranek: Nebraska Health and Human Services System, 301 Centennial Mall South, PO Box 95007, Lincoln, NE 68509-5007.
Drs. Vogt and Perz: Division of Viral Hepatitis, Centers for Disease Control and Prevention, 1600 Clifton Road, MS G-37, Atlanta, GA 30333.
Dr. Moolenaar: Air Pollution and Respiratory Health Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-17, Atlanta, GA 30333.
Author Contributions: Conception and design: A. Macedo de Oliveira, K.L. White, T.M. Vogt, R.L. Moolenaar, J.F. Perz, T.J. Safranek.
Analysis and interpretation of the data: A. Macedo de Oliveira, K.L. White, D.P. Leschinsky, B.D. Beecham, T.M. Vogt, R.L. Moolenaar, J.F. Perz, T.J. Safranek.
Drafting of the article: A. Macedo de Oliveira, K.L. White, B.D. Beecham, R.L. Moolenaar, J.F. Perz, T.J. Safranek.
Critical revision of the article for important intellectual content: A. Macedo de Oliveira, K.L. White, B.D. Beecham, R.L. Moolenaar, J.F. Perz, T.J. Safranek.
Final approval of the article: A. Macedo de Oliveira, K.L. White, R.L. Moolenaar, J.F. Perz, T.J. Safranek.
Statistical expertise: K.L. White.
Obtaining of funding: T.J. Safranek.
Administrative, technical, or logistic support: A. Macedo de Oliveira, K.L. White, D.P. Leschinsky, B.D. Beecham, T.J. Safranek.
Collection and assembly of data: A. Macedo de Oliveira, K.L. White, D.P. Leschinsky, B.D. Beecham.
Macedo de Oliveira A, White KL, Leschinsky DP, Beecham BD, Vogt TM, Moolenaar RL, et al. An Outbreak of Hepatitis C Virus Infections among Outpatients at a Hematology/Oncology Clinic. Ann Intern Med. 2005;142:898-902. doi: 10.7326/0003-4819-142-11-200506070-00007
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Published: Ann Intern Med. 2005;142(11):898-902.
Hepatitis C virus (HCV) may be transmitted through health care–associated exposure involving poor aseptic technique.
In an outpatient hematology/oncology clinic, 99 patients who did not have previously known HCV infection acquired the virus, apparently because a health care worker reused contaminated syringes and saline bags.
Researchers may have missed some cases because the investigation occurred more than a year after the outbreak.
We need active, effective infection-control programs for outpatient care settings.
Hepatitis C virus (HCV) infection is a leading cause of chronic liver disease in the United States (1). It is transmitted primarily through percutaneous exposure to contaminated blood (2). Health care–associated HCV transmission has been attributed to breaches in aseptic technique (3-5). In September 2002, a gastroenterologist notified the Office of Epidemiology at the Nebraska Health and Human Services System in Lincoln, Nebraska, of a cluster of 4 HCV genotype 3a infections in patients who received care at a single outpatient clinic in eastern Nebraska. Because these patients reported no typical risk factors for HCV infection and genotype 3a accounts for less than 8% of HCV infections in the United States, we suspected health care–associated transmission (1).
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