Italian researchers from the Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani, in Rome, conducted a series of scientific surveys of hepatitis B virus (HBV) outbreaks, which occurred in the European Union and the United States. More than 33 such events were analyzed, and the team published its finds in the open-access journal BMC Medicine. Results show that one of the most widespread methods the pathogen employs to get inside the human body is through injections using multi-vial compounds.
Another way in is through routine operations such as capillary blood sampling – used for glucose monitoring, most of the times – when performed with non-disposable medical devices. “HBV remains an important cause of liver disease in developed countries. Moreover, the virus has long been recognized as one of the most insidious viral agents within health care settings, and in fact a number of HBV outbreaks in health care are reported yearly in the USA and the European Union,” Simone Lanini, the leader of the current research, explained.
“Our review highlights several topical factors. Firstly, we found that dialysis units accounted for the highest number of outbreaks (10 out of 33), and that such outbreaks were the ones with the shortest duration and the fewest number of cases. These data might be explained by the fact that, both in USA and in most of EU countries, dialysis units have widely improved and mandatory protocols for serological surveillance of blood-borne infections. The consciousness of the risk of HBV transmission might also explain the higher frequency of reporting in dialysis units than in other settings. We also found that the highest number of such outbreaks were associated with the use of multi-vials, which is not unexpected,” the research paper also found.
The BMC Medicine study includes some 30 papers, reporting on a total of 33 outbreaks affecting 471 patients. The analyzed outbreaks, 17 of which occurred in the United States and 16 in the European Union, took place between 1992 and 2007. Sixteen of these people died due to the acquired infections. The researchers found that most of the outbreak victims were already suffering from other medical conditions, usually ones associated with a higher risk of having their immune systems affected.
“We have found that several breaches in infection control measures, related to some routine clinical practices thought to be risk-free (e.g. point of care blood glucose monitoring or preparation and administration of common parenteral drugs with multi-vial compounds) could result in patient-to-patient transmission of HBV,” the paper concluded.
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