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The index case of hepatitis C virus (HCV) that triggered a massive testing effort of patients in a Tulsa, OK dental practice rife with infection control failings appears to be the first documented case of HCV infection via cross-transmission between patients in a dental office, Hospital Infection Control & Prevention has learned.
The investigation into the dental and oral surgery practice of Wayne Scott Harrington, DMD, began after public health officials discovered one of his patients recently tested positive for hepatitis C virus with no other known risk factors (i.e., IV drug use). The subsequent investigation revealed a staggering array of alleged infection control violations, including the kind of misuse of needles and multidose vials that have resulted in cross transmission of bloodborne infections between patients in pain clinics, endoscopy centers and hospitals. In inspections conducted while the office was still open, public health officials also observed multiple sterilization issues, dental assistants providing IV sedation procedures, and the drug cabinet unlocked and unattended.(1)
While epidemiologically historic, the first documented case of HCV cross-transmission in dentistry has a troubling corollary: More than 3 million people in the United States have chronic HCV, many of whom are asymptomatic but have circulating virus that can be transmitted by blood. Some untold number of them are entering dental settings every day, potentially exposing other patients in offices that have lax infection control safeguards.
“At this juncture, it’s difficult to say whether patient-to-patient transmission of HCV in dental surgical settings is extremely rare or whether there are more occurrences nationwide that have gone unrecognized because dental surgical practices have not been scrutinized as closely as other outpatient medical facilities for healthcare-associated transmission of bloodborne pathogens,” says Kristy Bradley, DMV, MPH, lead investigator in the case and state epidemiologist at the Department of Health in Oklahoma City.
For more on this story see the May 2o13 issue of Hospital Infection Control & Prevention
1. Oklahoma Board of Dentistry. Statement of complaint against Wayne Scott Harrington, DMD. March 28, 2013. Available at: http://www.ok.gov/dentistry/