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


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


Calles, D. L.,Collier, M. G.,Khudyakov, Y.,Mixson-Hayden, T.,VanderBusch, L.,Weninger, S.,Miller, T. K.

American Journal of Infection Control


Virus targets
Hepatitis B
Hepatitis C
Other targets
Screening and diagnosis
Target populations
General Population
Country of development
United States of America
Target location
United States of America
Testing strategy
Point-of-care antibody test (rapid test), Laboratory-based PCR/RNA (confirmatory) test
Point-of-care antibody test (rapid test)
Laboratory-based PCR/RNA (confirmatory) test
Countries of included studies
United States of America

Health outcomes

Number new diagnoses

Testing strategy

Laboratory-based PCR/RNA (confirmatory) test,Point-of-care antibody test (rapid test)


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. Copyright © 2017

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21 Jan 2021