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

Anders Widell, Bertil Christensson, Thomas Wiebe, Claës Schalén, Hans Bertil Hansson, T Allander, M A Persson

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102 Citations (SciVal)


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.
Original languageEnglish
Pages (from-to)130-134
JournalAnnals of Internal Medicine
Issue number2
Publication statusPublished - 1999

Bibliographical note

The information about affiliations in this record was updated in December 2015.
The record was previously connected to the following departments: Division of Infection Medicine (SUS) (013008000), Clinical Microbiology, Malmö (013011000), Paediatrics (Lund) (013002000), Division of Medical Microbiology (013250400)

Subject classification (UKÄ)

  • Infectious Medicine
  • Pediatrics
  • Microbiology in the medical area


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