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

Widell, Anders LU ; Christensson, Bertil LU ; Wiebe, Thomas LU ; Schalén, Claës LU ; Hansson, Hans Bertil; Allander, T and Persson, M A (1999) In Annals of Internal Medicine 130(2). p.130-134
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Internal Medicine
volume
130
issue
2
pages
130 - 134
publisher
American College of Physicians
external identifiers
  • pmid:10068359
  • scopus:0033582180
ISSN
0003-4819
language
English
LU publication?
yes
id
359398e5-1068-4060-bbfb-154be9fdab85 (old id 1115418)
alternative location
http://annals.highwire.org/cgi/reprint/130/2/130
date added to LUP
2008-07-08 09:19:28
date last changed
2017-01-08 04:06:59
@article{359398e5-1068-4060-bbfb-154be9fdab85,
  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.},
  author       = {Widell, Anders and Christensson, Bertil and Wiebe, Thomas and Schalén, Claës and Hansson, Hans Bertil and Allander, T and Persson, M A},
  issn         = {0003-4819},
  language     = {eng},
  number       = {2},
  pages        = {130--134},
  publisher    = {American College of Physicians},
  series       = {Annals of Internal Medicine},
  title        = {Epidemiologic and molecular investigation of outbreaks of hepatitis C virus infection on a pediatric oncology service},
  volume       = {130},
  year         = {1999},
}