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Unsafe glucose monitoring practices led to HBV outbreak in assisted-living facility
Moore Z. MMWR. 2011;60:182.
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The North Carolina Division of Public Health and the Wayne County Health Department responded to an eight-person outbreak of acute hepatitis B virus in an assisted-living facility on Oct. 12. The department and the division of public health identified unsafe practices of finger-prick devices and blood glucose meters among residents with diabetes, according to data published in the Morbidity and Mortality Weekly Report.
According to background data in the study, sharing of blood glucose monitoring equipment in assisted-living facilities has resulted in at least 16 outbreaks of HBV infection in the United States since 2004.
“HBV transmission continues to occur through sharing of finger-stick lancing devices and other blood glucose monitoring equipment,” the researchers wrote. “These practices put residents at risk for severe illness and death.”
Infection control practices were examined via observations and interviews with faculty staff. Those who resided in the facility from Jan. 1 to Oct. 13, 2010, were tested, and their records were reviewed for health care-associated exposures, as well as HBV-related risk factors.
Of 87 residents, eight met the case definition for HBV. All eight residents were hospitalized, and six died of hepatitis complications. The eight patients had been assisted by the facility staff with blood glucose monitoring.
Officials identified that finger-prick devices and blood glucose meters approved for single-use only were shared between patients, and neither of the devices were cleaned or disinfected between patients, according to the report.
“In accordance with North Carolina Division of Public Health recommendations, the facility now uses individually assigned blood glucose meters and single-use, auto disabling finger-stick lancing devices,” the researchers said. “The facility also offered HBV vaccine to all susceptible residents. North Carolina Division of Public Health and the state licensing agency issued a notification to all health care providers and licensed health care facilities statewide warning of the potential for HBV transmission through unsafe diabetes-care practices. This outbreak underscores the need for increased efforts to promote compliance with infection-control guidelines in assisted-living facilities.”
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