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A Cluster of Hepatitis C Virus Infections Associated With Ozone-Enriched Transfusion of Autologous Blood in Rome, Italy

Published online by Cambridge University Press:  21 June 2016

Annunziata Faustini*
Affiliation:
from the Department of Epidemiology, Local Health Authority, Rome, Italy
Maria R. Capobianchi
Affiliation:
from the National Institute of Infectious Diseases “Lazzaro Spallanzani”, Rome, Italy
Mauro Martinelli
Affiliation:
from the General Hospital, “Villa San Pietro, ” Rome, Italy
Isabella Abbate
Affiliation:
from the National Institute of Infectious Diseases “Lazzaro Spallanzani”, Rome, Italy from the Hospital, “Sandro Pertini, ” Rome, Italy
Giuseppina Cappiello
Affiliation:
from the National Institute of Infectious Diseases “Lazzaro Spallanzani”, Rome, Italy
Carlo A Perucci
Affiliation:
from the Department of Epidemiology, Local Health Authority, Rome, Italy
*
Department of Epidemiology, LHA PME, via Santa Costanza n. 53, 00198 Rome, Italy. , faustini@asplazio. it

Abstract

Objective:

To describe an outbreak of hepatitis C virus (HCV).

Design:

Retrospective cohort study.

Setting:

Outpatient department of a hospital in Rome, Italy.

Patients:

All 42 patients exposed to ozone therapy by autohemotherapy or intramuscular injection from January to June 2001.

Methods:

Epidemiologic investigation, serologic analysis, and virus genotyping.

Results:

Thirty-one (74%) of the patients agreed to participate in the study. Three (9.7%) had symptoms of HCV infection. This incidence rate was higher than the rate of 1.4 per 100,000 per year in the regional population. Six patients were positive for HCV antibodies and HCV RNA for a prevalence rate of 19.4%, which was much higher than the estimate of 0.9% in the population. Virus genotype lb was found in two case-patients (one symptomatic) and 2c in four case-patients (two symptomatic), one of whom was known to have an HCV infection since 1986 and could have been the source of infection. The infected patients were all being exposed to ozone-enriched transfusions of autologous blood. Although the specific mode of transmission between patients was not detected, transmission probably occurred during one of the three busiest therapeutic sessions in the 6-month period.

Conclusions:

Transmission of HCV infection may occur during medical procedures with limited bleeding. Standard precautions must be applied in any healthcare setting; restricting the number of individuals treated during each therapeutic session could be an effective way of avoiding accidental transmission of infection.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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References

1.Allander, T, Medin, C, Jacobson, SH, Grillner, L, Persson, MA.Hepatitis C transmission in a hemodialysis unit: molecular evidence for spread of virus among patients not sharing equipment. J Med Virol 1994;43:415419.CrossRefGoogle Scholar
2.Stuyver, L, Claeys, H, Wyseur, A, et al.Hepatitis C virus in a hemodialysis unit: molecular evidence for nosocomial transmission. Kidney Int 1996;49:889895.Google Scholar
3.Izopet, J, Pasquier, C, Sandres, K, Puel, J, Rostaing, L.Molecular evidence for nosocomial transmission of hepatitis C virus in a French hemodialysis unit. J Med Virol 1999;58:139144.Google Scholar
4.Allander, T, Gruber, A, Naghavi, M, et al.Frequent patient-to-patient transmission of hepatitis C virus in a haematology ward. Lancet 1995;345:603607.Google Scholar
5.Widell, A, Christensson, B, Wiebe, T, et al.Epidemiologic and molecular investigation of outbreaks of hepatitis C virus infection on a pediatric oncology service. Ann Intern Med 1999;130:130134.CrossRefGoogle ScholarPubMed
6.Bronowicki, JP, Venard, V, Botté, C, et al.Patient-to-patient transmission of hepatitis C virus during colonoscopy. N Engl J Med 1997;337:237240.Google Scholar
7.Andrieu, J, Barny, S, Colardelle, P, et al.Prevalence and risk factors of hepatitis C virus infection in a hospitalized population in a gastroenterology unit: role of endoscopic biopsies [in French]. Gastroenterol Clin Biol 1995;19:340345.Google Scholar
8.Schvarcz, R, Johansson, B, Nystrom, B, Sonnenborg, A.Nosocomial transmission of hepatitis C virus. Infection 1997;25:7477.Google Scholar
9.Lutz, CT, Bell, CE, Wedner, HJ, Krogstad DJ., Allergy testing of multiple patients should no longer be performed with a common syringe. N Engl J Med 1984;310:13351337.Google Scholar
10.Desenclos, J-C, Bourdiol-Razes, M, Rolin, B, et al.Hepatitis C in a ward for cystic fibrosis and diabetic patients: possible transmission by spring-loaded finger-stick devices for self-monitoring of capillary blood glucose. Infect Control Hosp Epidemiol 2001;22:701707.Google Scholar
11.Gabriel, C, Blauhut, B, Greul, R, Schneeweis, B, Roggendorf, M. Transmission of hepatitis C by ozone enrichment of autologous blood. Lancet 1996;347:541.Google Scholar
12.Daschner, FD. Hepatitis C and human immunodeficiency virus infection following ozone autohaemotherapy. Eur J Clin Microbiol Infect Dis 1997; 16:620.CrossRefGoogle ScholarPubMed
13.Bocci, V. Biological and clinical effects of ozone: has ozone therapy a future in medicine? Br J Biomed Sci 1999;56:270279.Google Scholar
14.Bocci, V. Autohaemotherapy after treatment of blood with ozone: a reappraisal. J Int Med Res 1994;22:131144.Google Scholar
15.Norder, H, Bergstrom, A, Uhnoo, I, et al.Confirmation of nosocomial transmission of hepatitis C virus by phylogenetic analysis of the NS5-B region. J Clin Microbiol 1998;36:30663069.Google Scholar
16.Enomoto, N, Kurosaki, M, Tanaka, Y, Marumo, F, Sato, C. Fluctuation of hepatitis C virus quasispecies in persistent infection and interferon treatment revealed by single-strand conformation polymorphism analysis. J Gen Virol 1994;75:13611369.Google Scholar
17.Sandres, K, Dubois, M, Pasquier, C, et al.Genetic heterogeneity of hypervariable region 1 of the hepatitis C virus (HCV) genome and sensitivity of HCV to alpha interferon therapy. J Virol 2000;74:661668.CrossRefGoogle ScholarPubMed
18.Kumar, S, Tamura, K, Jakobsen, IB, Nei, M. MEGA3: integrated software for molecular evolutionary genetics analysis and sequence alignment. Briefings in Bioinformatics 2004;5:150163.CrossRefGoogle ScholarPubMed
19.Campello, C, Poli, A, Dal, MG, Besozzi-Valentini, F. Seroprevalence, viremia and genotype distribution of hepatitis C virus: a community-based population study in northern Italy. Infection 2002;30:712.CrossRefGoogle ScholarPubMed
20.De Socio, GV, Francisci, D, Mecozzi, F, et al.Hepatitis C virus genotypes in the liver and serum of patients with chronic hepatitis C. Clin Microbiol Infect 1996;2:2024.Google Scholar
21.Abacioglu, YH, Bacaksiz, F, Bahar, IH, Simmonds, P. Molecular evidence of nosocomial transmission of hepatitis C virus in a haemodialysis unit. Eur J Clin Microbiol Infect Dis 2000;19:182186.Google Scholar
22.Halfon, P, Roubicek, C, Gerolami, V, et al.Use of phylogenetic analysis of hepatitis C virus (HCV) hypervariable region 1 sequences to trace an outbreak of HCV in an autodialysis unit. J Clin Microbiol 2002; 40:15411545.Google Scholar
23.Bruguera, M, Saiz, J, Franco, S, et al.Outbreak of nosocomial hepatitis C virus infection resolved by genetic analysis of HCV RNA. J Clin Microbiol 2002;40:43634366.Google Scholar
24.Mizuno, M, Higuchi, T, Kanmatsuse, K, Esumi, M. Genetic and serological evidence for multiple instances of unrecognized transmission of hepatitis C virus in hemodialysis units. J Clin Microbiol 1998;36:29262931.Google Scholar