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. 2017 Feb 1;45(2):126-132.
doi: 10.1016/j.ajic.2016.08.013. Epub 2016 Nov 2.

Hepatitis C virus transmission in a skilled nursing facility, North Dakota, 2013

Dinorah L Calles  1 , Melissa G Collier  2 , Yury Khudyakov  2 , Tonya Mixson-Hayden  2 , Lindsey VanderBusch  3 , Sarah Weninger  3 , Tracy K Miller  3 ; North Dakota Hepatitis C Virus Investigation Team
Affiliations

Hepatitis C virus transmission in a skilled nursing facility, North Dakota, 2013

Dinorah L Calles et al. Am J Infect Control. .

Abstract

Background: From March-May 2013, 3 cases of acute hepatitis C virus (HCV) infection were diagnosed among elderly patients residing at the same skilled nursing facility (facility A) and who received health care at hospital X during their likely exposure period.

Methods: We performed HCV testing of at-risk populations; quasispecies analysis was performed to determine relatedness of HCV in persons with current infection. Infection control practice assessments were conducted at facility A and hospital X. Persons residing in facility A on September 9, 2013, were enrolled in a case-control study to identify risk factors for HCV infection.

Results: Forty-five outbreak-associated infections were identified. Thirty cases and 62 controls were enrolled in the case-control study. Only podiatry (odds ratio, 11.6; 95% confidence interval, 2.4-57.2) and international normalized ratio monitoring by phlebotomy (odds ratio, 6.7; 95% confidence interval, 1.7-26.6) at facility A were significantly associated with case status. Infection control lapses during podiatry and point-of-care testing procedures at facility A were identified.

Conclusions: HCV transmission was confirmed among residents of facility A. The exact mode of transmission was not able to be identified, but infection control lapses were likely responsible. This outbreak highlights the importance of prompt reporting and investigation of incident HCV infection and the need for adherence to basic infection control procedures by health care personnel.

Keywords: Hepatitis C virus; Infection control; Skilled nursing facility.

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