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Hepatitis C Infection

By Lisa Schulmeister, RN, MN, APRN-BC, OCN, FAAN

Many news outlets are covering the alleged hepatitis C transmission by radiologic technologist David Kwiatkowski. He’s the temporary worker who was hired via a staffing agency to work at a New Hampshire hospital and transmitted hepatitis C through infected syringes. The news reporters for the most part are focusing on the staffing industry and how unregulated it is, since Kwiatkowski apparently had a questionable employment record.

The bigger issue is hepatitis C transmission to innocent patients. Guh and colleagues examined records of events that involved communications to groups of patients, conducted during 2001-2011, advising bloodborne pathogen testing stemming from potential exposures to unsafe injection practices. They identified 35 patient notification events related to unsafe injection practices in 17 states, resulting in 130,198 patients needing to be notified. The primary breach identified (>=16 events; 44%) was syringe reuse to access shared medications and this is the alleged cause of the outbreak attributed to Kwiatkowski. Twenty-two (63%) notifications stemmed from the identification of viral hepatitis transmission, and 13 (37%) were prompted by the discovery of unsafe injection practices, absent evidence of bloodborne pathogen transmission. The researchers concluded that increased oversight and attention to basic infection control are needed to maintain patient safety.

Education also is needed. The One & Only Campaign is a public health campaign, led by the Centers for Disease Control and Prevention (CDC) and the Safe Injection Practices Coalition (SIPC), to raise awareness among patients and healthcare providers about safe injection practices. The campaign aims to eradicate outbreaks resulting from unsafe injection practice and information and resources can be found at


Guh AY, Thompson ND, Schaefer MK, et al. Patient notification for bloodborne pathogen testing due to unsafe injection practices in the US health care settings, 2001-2011. Medical Care. 2012; doi: 10.1097/MLR.0b013e31825517d4.
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