Infection Control Problems Result in Increased Hepatitis C Reports at Dialysis Centers: CDC

A new report urges dialysis centers throughout the United States to adopt better screening and testing practices, which are designed to identify patients with hepatitis C and prevent infection outbreaks among patients. 

In the latest issue of the U.S. Centers for Disease Control and Prevention (CDC)’s Morbidity and Mortality Weekly Report, federal health officials indicate that between 2014 and 2015, there were at least 36 new cases of hepatitis C infections contracted by patients at 19 kidney dialysis clinics in eight states.

The CDC’s report stated that hepatitis C infections are steadily increasing, in part due to poor infection control practices at dialysis centers.

Hepatitis C is a liver infection that is caused by contracting the hepatitis C virus (HCV). The infection is a blood-borne virus that can cause long term liver disease and if not treated may result in chronic infections that can lead to lifelong liver complications and even death. The virus is spread by open exposure of infected blood, and transmissions of the virus are usually a result of sharing needles or other medical equipment to inject drugs.

According to the CDC, reports of hepatitis C infections are on the rise throughout the United States, and some are being reported from kidney dialysis clinics, where more than 400,000 people undergo kidney dialysis treatments each year. Dialysis treatment is an essential, life-saving medical treatment given to individuals with advanced kidney disease and includes hooking patients up to a special machine that uses IV’s to filter harmful wastes, salt, and excess fluid from the patients’ blood.

The CDC reports that since the beginning of 2014, 36 new cases of hepatitis C hospital acquired infections have been reported from 19 kidney dialysis clinics in eight states.

To date, CDC investigators have been able to determine that 9 of the 36 new infections were a direct result of patient-to-patient HCV transmission, but have not been able to identify exactly how the transmissions occurred. The information provided suggests that the newly infected patients entered the kidney dialysis centers without any HCV symptoms or risks and at some point while in the care of the kidney dialysis clinics, contracted the virus.

Lack of infection control practices such as injection safety procedures, cleaning and disinfections, and hand hygiene were the assumed transmission method, according to health investigators at the CDC. According to investigators, although no specific event or act could pinpoint the reason for transmissions, a combination of poor infection control practices are the reasoning behind the hepatitis C outbreaks.

Proper screenings, utensil and surface cleanings and general awareness of the risk of hepatitis C infection could help prevent outbreaks in healthcare facilities, the CDC investigators claimed. According to the investigators, it was visually apparent to see how infections could spread easily at the clinics due to poor disinfection practices.

A major contributor to the outbreak of HCV is the lack of patient screening when entering a facility and throughout the duration of their stay. If patients enter a facility with the infection and undergoes kidney dialysis treatment which requires incisions and IV injections, the medical devices or room they were located in is a prime carrier of the virus.

The CDC states that “any new case of hepatitis C infection in a dialysis patient is likely to be a health facility-associated infection” and that these infections should be reported to public health authorities immediately to prevent further outbreaks.

Dialysis clinics are being urged to assess and improve infection control methods, HCV screening practices, and proper disinfection protocols whether there have been reported HCV infections in patients or not. Patients are being encouraged to consult their healthcare providers about being tested for HCV and to always ask your dialysis provider if their clinic follows recommended CDC sterilization and testing policies. Patients should always ask what else can be done to limit your exposure to potential Hepatitis C infections during treatment.