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Hepatitis C Investigation Information

Public Health has initiated an investigation of hepatitis C virus (HCV) infection. At this time, potential exposure to HCV associated with this investigation may have occurred only in patients who:

  • Visited the emergency department at McKay-Dee Hospital between June 17, 2013 and November 25, 2014 and received certain medications, OR
  • Visited the emergency department at Davis Hospital and Medical Center between June 17, 2011 and April 11, 2013 and received certain medications.

Public health is currently working with the all healthcare facilities involved to identify potentially exposed individuals. Potentially exposed individuals will receive a letter in the mail from McKay-Dee Hospital or Davis Hospital and Medical Center. This letter will explain the situation; provide information about HCV, and review steps the individual can take to receive free HCV testing.

For more information regarding testing at McKay-Dee Hospital, contact McKay-Dee Hospital at 801-387-8580 or visit McKay-Dee Hospital's website.

For more information regarding testing at Davis Hospital and Medical Center, contact Davis Hospital and Medical Center at 801-807-7383.

Additional cases have been identified in connection with this Hepatitis C investigation. We are not releasing exact numbers until further investigation is completed.

Those who received a letter from McKay Dee Hospital or Davis Hospital and Medical Center related to this investigation are encouraged to get tested before January 31, 2016.

No public health quarantine or isolation will be issued since HCV is not spread through coughing, sneezing, or sharing food and beverages.

Frequently Asked Questions

How did this happen?

Utah public health learned of the potential exposure at McKay-Dee Hospital during a routine disease investigation for HCV infection. As the scope of the public health investigation broadened, we learned of potential exposure at Davis Hospital and Medical Center. We do not know the exact source of contamination between the employee and the patient who contracted HCV genotype 2b infection.

How do I know if I was exposed?

Potentially exposed individuals will receive a letter in the mail from McKay-Dee Hospital or Davis Hospital and Medical Center. This letter will explain the situation, provide information about HCV, and review steps the individual can take to receive free HCV testing.

Why has it taken this long for the patients to be contacted about their possible exposure to HCV?

We try to balance being fast, with being thorough and accurate. Disease investigations take time. There are specific protocols and epidemiologic methods used to rule out disease, identify contacts and exposures, conduct testing and confirm disease. Prior to making this information public, we needed to ensure we were able to identify potential contacts and establish a system for providing those contacts with necessary follow-up testing.

Additionally, it can take years for symptoms of HCV infection to develop. The HCV infection in the original patient was discovered only after a routine screening test was performed; the patient had no symptoms at the time. Public health is continuing to work with McKay-Dee Hospital and Davis Hospital and Medical Center to report accurate information and ensure patient confidentiality.

How common is this type of exposure in healthcare facilities?

While there have been reports of HCV transmitted from a hospital employee to a patient, the risk of transmission appears to be very low. There are no recommendations from the Centers for Disease Control and Prevention (CDC) to restrict a healthcare worker who is infected with HCV infection. All healthcare personnel, including those who are HCV positive, should follow strict procedures to keep patients free from infection. The use of Standard Precautions, including appropriate hand hygiene, use of protective barriers, and safe injection practices assist with this goal.

What is public health doing to prevent further spread of HCV?

The Utah Department of Health (UDOH) and Local Health Departments (LHDs) are working with McKay-Dee Hospital, Davis Hospital and Medical Center and the Centers for Disease Control and Prevention (CDC) in the current HCV investigation to ensure that all potentially exposed people are tested and connected to medical care when appropriate. Public health conducts thorough investigations of acute HCV cases to identify risk factors, determine the source of infection, and identify other people who may have been exposed and refer them for medical management when appropriate.

What does a public health investigation for HCV include?

Key components of an investigation include confirming the diagnosis and interviewing the infected individual to determine potential risk factors for infection, including assessing travel history and collecting medical history. The investigator may request additional testing for the individual, referring him or her to further medical management. Depending on the initial findings of the investigation, the investigator may review infection control practices and review medical records in locations where HCV transmission may have occurred. The goals of the investigation are to identify and follow-up with other potentially infected individuals, refer them to care, and prevent further transmission. All disease investigations are conducted with the utmost patient confidentiality and follow specific public health protocols.

What is being done to prevent this from happening again?

The Utah Department of Health provides education to healthcare providers and healthcare facilities on infectious diseases, including prevention, reporting and medical management, and will continue to do so. The Utah Department of Health is also collaborating with other partners such as local health departments, Centers for Disease Control and Prevention, and the Utah Department of Professional Licensing to discuss additional strategies for preventing healthcare-associated infections.

Who is at risk?

Only people who visited McKay-Dee Hospital or Davis Hospital and Medical Center during specific dates and received specific medications are at potential risk for exposure associated with this investigation. People who have potentially been exposed will receive notification in a letter by mail from McKay-Dee Hospital or Davis Hospital and Medical Center with additional information about testing.

If you do not receive a letter from McKay-Dee Hospital or Davis Hospital and Medical Center, there is no risk of exposure as part of this investigation, and you do not need to take any action. But if you are concerned, and would like more information, contact McKay-Dee Hospital at 801-387-8580 or visit McKay-Dee Hospital's website, or contact Davis Hospital and Medical Center at 801-807-7383.

Even if you are not associated with this particular investigation, you may still be at risk for HCV infection if you meet any of the risk factors listed below. People commonly at increased risk for HCV and should consider testing include:

Common Risk Factors

  • People born between 1945 and 1965
  • Current injection drug users (currently the most common way HCV is spread in the United States)
  • Past injection drug users, including those who injected only one time or many years ago and shared drug injection equipment of any kind
  • Recipients of donated blood, blood products and organs before 1992
  • People who received a blood product for clotting problems made before 1987
  • Hemodialysis patients or persons who spent many years on dialysis for kidney failure
  • People who received body piercing or tattoos done with non-sterile instruments or by a non-licensed facility
  • People with known exposures to the HCV, such as health-care workers injured by needle sticks , or who were exposed to splashing/splattering of blood or recipients of blood or organs from a donor who tested positive to HIV
  • HIV-infected persons
  • Children born to mothers infected with HIV
  • Less common risks include:

  • Having sexual contact with a person who is infected with HCV; or
  • Sharing personal care items, such as razors or toothbrushes that may have come in contact with the blood of an infected person.
  • Hepatitis C Virus (HCV) Infection

    What is HCV infection?

    Hepatitis C is an infection of the liver that results from the hepatitis C virus (HCV). HCV is one of the most common types of viral hepatitis in the United States. Others include hepatitis A and hepatitis B. There are six distinct genotypes or classifications of HCV with multiple subtypes in each genotype class.

    How is HCV spread?

    HCV is spread when blood from a person infected with HCV enters the body of someone who is not infected. Most people become infected with HCV by sharing needles or other equipment to inject drugs, receiving donated blood, blood products and organs before 1992, and needle stick injuries in healthcare settings. People have also become infected with HCV from body piercings or tattoos received in prisons, homes, or in other unlicensed or informal facilities. In rare cases, HCV may be sexually transmitted. Babies born to mothers with HCV can get infected during childbirth.

    HCV is NOT spread by casual contact, including: sharing eating utensils, breastfeeding, hugging, kissing, holding hands, coughing, or sneezing. It is also not spread through food or water.

    Can HCV be spread within a household?

    Yes, but this does not occur very often. If HCV is spread within a household, it is most likely a result of direct, through-the-skin exposure to the blood of an infected household member.

    How long does the HCV survive outside the body?

    The HCV can survive outside the body at room temperature, on environmental surfaces, for up to three weeks.

    What is the risk of a pregnant woman passing HCV to her baby?

    HCV is rarely passed from a pregnant woman to her baby. About 6 of every 100 infants born to mothers with hepatitis C become infected with the virus. However, the risk becomes greater if the mother has both HIV infection and HCV infection. If you have a positive HCV test and are currently pregnant, or planning to become pregnant, it is recommended that you see your healthcare provider in a timely manner.

    What is the risk of acquiring HCV from transfused blood or blood products in the United States?

    Now that more advanced screening tests for HCV are used in blood banks, the risk is considered to be less than 1 in 2 million units transfused. Before 1992, when blood screening for HCV became available, blood transfusion was a leading means of HCV transmission.

    What are the signs and symptoms of HCV?

    For some people, hepatitis C is an acute (short-term) illness, but for 75%–85% of people who become infected with hepatitis C, it becomes a chronic (long-term) infection. Approximately 70%–80% of people with acute HCV do not have any symptoms. About 6-7 weeks after exposure, the following signs and symptoms occur in a small portion of infected people:

  • Nausea or poor appetite
  • Stomach pain
  • Dark-colored urine/clay-colored stools
  • Yellow discoloration in the skin and eyes (jaundice)
  • Fever
  • Muscle and joint pains
  • How long after infection do symptoms appear?

    Symptoms usually don’t occur until late in the course of chronic (long-term illness) infection, up to 25 years after the initial infection. For the few infected persons who develop acute symptoms, the average time is 6-7 weeks after exposure, but this can range from 2 weeks to 6 months.

    How will I know I have HCV if I don’t have any symptoms?

    You may not know if you are infected. That is why it is so important to get tested, especially if you were born between 1945 and 1965, have certain risk factors or have been exposed to someone who has HCV.

    It is important to note that the ONLY people at potential risk for HCV exposure in this investigation include:

  • People who visited the emergency department at McKay-Dee Hospital between June 17, 2013 and November 25, 2014 and received certain medications, OR
  • People who visited the emergency department at Davis Hospital and Medical Center between June 17, 2011 and April 11, 2013 and received certain medications.
  • People who have potentially been exposed will receive notification from McKay-Dee Hospital or Davis Hospital and Medical Center with further information about testing.

    If you do not receive a letter from McKay-Dee Hospital or Davis Hospital and Medical Center, there was no risk of exposure as part of this investigation, and you do not need to take any action. But if you are concerned, and would like more information, please contact McKay-Dee Hospital at 801-387-8580, or Davis Hospital and Medical Center at 801-807-7383.

    Can a person donate blood, organs, or semen if he/she has HCV?

    No, if a person has ever tested positive for HCV (or HIV or Hepatitis B virus), experts recommend never donating blood, organs, or semen because this can spread the infection to the recipient.

    Should a person infected with HCV be restricted from working in certain jobs or settings?

    The CDC recommends that people should not be excluded from work, school, play, child care, or other settings because they have HCV. There is no evidence that people can get HCV from food handlers, teachers, or other service providers without blood-to-blood contact. As recommended for all healthcare workers, those who are HCV-positive should follow strict standard precautions, including appropriate use of hand washing, protective barriers, and care in the use and disposal of needles and other sharp instruments.

    How can hepatitis C virus be prevented?

    Although there is currently no vaccine to prevent HCV infection, there are ways to reduce the risk of becoming infected with HCV.

  • Avoid sharing or reusing needles, syringes, or any other equipment to prepare and inject drugs, steroids, hormones, or other substances.
  • Do not use personal items that may have come into contact with an infected person’s blood, even in amounts too small to see, such as razors, nail clippers, toothbrushes, or glucose monitors.
  • Do not get tattoos or body piercings from an unlicensed facility or in an informal setting (e.g., during incarceration).
  • If you are a healthcare worker, follow your institution’s safety precautions.
  • If you have more than one sex partner or are a man having sex with other men, use condoms for sexual intercourse.
  • Testing

    If you are notified by McKay-Dee Hospital or Davis Hospital and Medical Center, testing will be provided at no cost to you, and you will be connected to medical care if needed. For more information about testing, contact McKay Dee Hospital at 801-387-8580 or visit McKay Dee Hospital's website, or contact Davis Hospital and Medical Center at 801-807-7383.

    Several different blood tests are used to test for HCV. Your healthcare provider may order one or a combination of these tests. Typically, a person will first get a screening antibody test (anti-HCV) that will show whether he or she has ever been infected with HCV and developed antibodies to HCV. (An antibody is a substance found in the blood that the body produces in response to a virus.) Having a positive antibody test means that a person was exposed to the virus at some time during his or her lifetime.

    If the antibody test is positive, a second test (polymerase chain reaction or PCR) will likely be ordered to confirm whether the virus is still present in a person’s bloodstream. If a person has tested positive for HCV PCR, it is important to identify the specific type of HCV to help determine the best type of treatment; the test to determine this is the HCV genotype test.

    How accurate is the blood test for HCV?

    Anti-HCV can be detected in >97% of people by six months after exposure.

    Are there other ways to confirm HCV other than the blood test?

    No. HCV is transmitted through exposure to infected blood. The only way to know if a person is infected with HCV is through a blood test.

    Treatment

    HCV is treatable, but is not usually treated unless it becomes chronic. Chronic HCV is treated with medicines that slow or stop the virus from damaging the liver, and there are several antiviral medications available. Success of treatment depends on many factors, including the specific type of HCV, previous treatment, liver failure and other infections. After a person has been diagnosed with chronic HCV infection, he/she should have an assessment of the degree of liver damage to help determine the type of treatment that will work best for them.

    If a person is successfully treated and has no detectable virus in the blood for more than six months, the person is considered cured and is no longer infectious to others. However, having had a past HCV infection does not mean you are immune to future HCV infections. You can be re-infected with HCV.

    Genotype 1 is the most common type of HCV genotype in the United States. Because there are various HCV types that respond differently to available drug therapies, knowing the genotype of HCV a person is infected with can result in better patient outcomes.

    If you are diagnosed with HCV as part of this investigation, you will be connected to medical care by McKay-Dee Hospital, Davis Hospital and Medical Center, or by public health. You may also choose to speak with your personal healthcare provider to determine the best treatment options for you. If you do not have a healthcare provider, contact your local health department or the Utah Department of Health at 801-538-6191 for more information. For a list of local health departments, click here.

    What long-term health problems can develop if someone with hepatitis C virus doesn’t receive treatment?

    Chronic infection with HCV can lead to scarring of the liver (cirrhosis). As the disease progresses, symptoms such as skin problems, blood disorders, and fever may appear. In the long term, HCV infection can lead to severe liver damage, liver cancer, and liver failure. Of every 100 people infected with HCV, about 75–85 people will develop chronic HCV infection; of those,

  • 60–70 people will go on to develop chronic liver disease
  • 5–20 people will go on to develop cirrhosis over a period of 20–30 years
  • 1–5 people will die from cirrhosis or liver cancer
  • Contacts

  • Mckay-Dee Hospital
  • 801-387-8580
  • Davis Hospital and Medical Center
  • 801-807-7383
  • Utah Department of Health, Bureau of Epidemiology
  • 801-538-6191
  • Utah Public Information Line
  • 1-800-456-7707
  • Resources

    Contact

    Utah Department of Health
    Bureau of Epidemiology
    801-538-6191
    Fax: 801-538-9913
    Email: epi@utah.gov
    288 North 1460 West
    PO Box 142104
    Salt Lake City, Utah 84114-2104

    24-Hour Urgent Event & Disease Reporting

    1-888-EPI-UTAH (374-8824)
     

    Regular Business Hours:

    Monday - Friday
    8:00 a.m. - 5:00 p.m.

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