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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Infected HCW may have spread hepatitis to patients

In a painfully familiar scenario, 20 patients have tested positive for the same strain of hepatitis C virus in what appears to be a case of blatant disregard for infection control with needles, syringes and vials by a drug-addicted health care worker, New Hampshire public health officials report.

Investigators suspect a drug-abusing hospital employee infected with HCV at Exeter (NH) Hospital was swapping sterile needles with contaminated ones, the Boston Globe reports. In addition to the 20 infected, some 700 patients are being advised to be tested for HCV, HIV and hepatitis B virus. Investigators believe that an infected worker pilfered sterile syringes containing drugs intended for patients, then replaced them with used syringes filled with water or saline to conceal the theft.

All infected patients had been treated in the hospital’s cardiac catheterization lab, which performs heart procedures and other surgeries. Exeter Hospital agreed to close the lab May 25 but reopened it June 5 after investigators from the state Division of Public Health Services found no evidence of contaminated equipment, the newspaper reported. The case is similar to other hepatitis outbreaks linked to drug-scavenging addicts, though many have also occurred because workers did not understand the basic principles of safe practice with needles and syringes. In such instances, cross transmission can occur when infected blood contaminates syringes or vials, particularly those that are subsequently re-entered to draw medication for a different patient.