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Transmission of hepatitis C virus from a surgeon to a patient. The Incident Control Team
G J Duckworth1, J Heptonstall, C Aitken
1East London and the City Health Authority, London. g.duckworth@cdsc.nthames.nhs.uk
Insights
A surgeon transmitted hepatitis C virus (HCV) genotype 4a to a patient during cardiothoracic surgery. This study investigated transmission and found a low transmission rate of 0.36% among exposed patients.
Area of Science:
- Hepatology
- Infectious Diseases
- Surgical Safety
Background:
- Hepatitis C virus (HCV) infection poses a significant public health concern.
- Understanding transmission routes is crucial for preventing healthcare-associated infections.
Observation:
- A patient developed HCV infection following cardiothoracic surgery.
- Virological analysis identified matching HCV genotype 4a in both the patient and the first assistant surgeon.
- No other infection sources were identified, including blood donors.
Findings:
- HCV transmission from surgeon to patient occurred during an exposure-prone procedure.
- The transmission rate in this incident was determined to be 0.36% (1/278 patients).
- Extensive follow-up testing of 277 other exposed patients revealed no additional HCV infections.
Implications:
- This case highlights the risk of surgeon-to-patient transmission of HCV during invasive procedures.
- Reinforces the importance of stringent infection control measures and screening for healthcare professionals.
- Emphasizes the need for vigilance in identifying and managing potential transmission events in surgical settings.
Abstract:
An investigation was carried out to find the source of infection in a patient who developed hepatitis C virus (HCV) infection after cardiothoracic surgery, and to determine whether other patients had become infected. Virological tests on specimens from the patient and potential sources (blood donors and members of the surgical team) showed that the patient and the surgeon who acted as first assistant were infected with HCV of the same genotype: 4a. No other source of infection was identified. Ninety-one per cent (277) of the 304 other exposed patients available for follow up were tested--none had antibody to HCV. It was concluded that hepatitis C may be transmitted from surgeon to patient during exposure prone procedures, and that the transmission rate in this incident was 0.36% (1/278; 95% confidence interval 0.0061%-1.98%).