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| |  Misuse of Anaesthesia Could Cause Hepatitis Virus Transmission BETHESDA, Md -- July 22, 2010 -- Hepatitis B virus (HBV) and hepatitis C virus (HCV) can be transmitted during intravenous (IV) administration of anaesthesia, according to a study published in Gastroenterology. In the study, physicians found that anaesthesia contamination -- not endoscopy contamination -- was the cause of infection. Efforts are needed to better educate the healthcare community on the importance of strict adherence to sterile techniques when using any form of anaesthesia. The study findings highlight the fact that many instances of healthcare-related HBV and HCV virus transmission probably go undetected. The true magnitude of this problem is therefore unknown. Physicians investigated an outbreak of acute HBV and HCV infections among patients who received anaesthesia during endoscopy procedures from the same anaesthesiologist in 2 different gastroenterology clinics. They identified 6 cases of outbreak-associated HCV infection and 6 cases of outbreak-associated HBV infection in 1 clinic; 1 outbreak-associated HCV infection was identified in a second clinic. All affected patients in both clinics received propofol from this anaesthesiologist, who inappropriately used a single-use vial of propofol for multiple patients. Reuse of syringes to re-dose patients, with resulting contamination of medication vials used for subsequent patients, likely resulted in viral transmission. These findings are consistent with other investigations of HBV and HCV infection in healthcare settings: contamination of anaesthesia or other IV medications was far more likely to be responsible for transmission of HBV or HCV than the equipment used in the patients' medical procedures. These results increase concerns regarding infection control practices and use of shared medication vials for anaesthesia administration to multiple patients, especially in outpatient settings where infection control oversight is limited and procedures such as endoscopies are increasingly performed. Physicians diagnosing patients with acute viral hepatitis should report these cases to their local health department and carefully consider the role of healthcare exposures, especially among those who do not report traditional risk factors for infection. Together, increased education and policies limiting use of medication vials to single patients for IV anaesthesia should reduce the risk for health care-associated HBV and HCV transmission.
SOURCE: American Gastroenterological Association
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