A nurse in Washington state likely infected at least a dozen patients with hepatitis C after she used injectable drugs that were meant for patients, according to a new report.
Health officials began investigating the outbreak early last year, when two patients developed hepatitis C between January and March 2018 after being treated at the same emergency room near Tacoma, Washington. Neither of the patients had typical risk factors for hepatitis C, but both had received injections of opioid drugs while in the ER, and were treated by the same nurse, according to the report, published this week by the Centers for Disease Control and Prevention (CDC).
The two patients also had genetically identical strains of hepatitis C, meaning that they were infected from the same source. (Hepatitis C is a liver infection caused by the hepatitis C virus, according to the CDC. Symptoms can include fever, fatigue, abdominal pain, nausea and jaundice – yellowing of the skin and/or eyes.) [27 Devastating Infectious Diseases]
Curiously, officials found that the nurse had accessed the hospital's automated drug-dispensing system at a much higher rate than other nurses had. She also tested positive for hepatitis C, and admitted "diverting" patient's drugs for her own use, the report said.
The nurse didn't say exactly how she diverted the drugs. In previous cases of people who contracted infections from health care workers, the workers first injected themselves with the patients' drugs and then refilled the syringe with water before injecting that into the patients, the report said. The nurse in this case may have also used part of the dose, and given the rest to the patient, using the same syringe.
After discovering the outbreak, officials reached out to nearly 3,000 people who had received injectable drugs at the hospital's emergency room during the time that the nurse worked at the facility (regardless of whether or not they were treated by the nurse.)
Of these, 13 people who were treated by the nurse tested positive for hepatitis C; all of them had strains of the virus that genetically matched the nurse's strain of the virus.
Among these patients, 12 had only recently developed hepatitis C; the other patient had a known chronic infection. The nurse in question may have acquired the virus from the patient with the chronic infection (who was treated at the hospital in November 2017), and subsequently infected the other 12 patients, the report said.
"Drug diversion by healthcare providers can pose serious infection risks for patients," the report said. "Health care facilities need to develop security measures and to actively monitor drug dispensing systems to detect and prevent narcotics and other drug diversion."
After identification of the outbreak, the nurse's license to practice was suspended.
The hospital affected wasn't named in the report, but last year, MultiCare Good Samaritan Hospital in Puyallup, Washington, issued a statement that acknowledged the outbreak investigation and apologized to patients who were infected.
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Originally published on Live Science.
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Rachael is a Live Science contributor, and was a former channel editor and senior writer for Live Science between 2010 and 2022. She has a master's degree in journalism from New York University's Science, Health and Environmental Reporting Program. She also holds a B.S. in molecular biology and an M.S. in biology from the University of California, San Diego. Her work has appeared in Scienceline, The Washington Post and Scientific American.