Original title: dozens of hemodialysis patients infected with hepatitis C in Dongtai, Jiangsu Province
According to caixin.com on the evening of May 26, hepatitis C infection broke out in hemodialysis patients in Dongtai people's Hospital of Yancheng City, Jiangsu Province. The infected people were found in April to May. Dozens of patients who received blood purification technology were detected to be infected with hepatitis C virus. The specific causes of infection are still under investigation. At present, the treatment cost of infected patients is borne by the hospital, but the hemodialysis room is still working normally.
"China Newsweek" to the Dongtai Municipal Health Commission to verify the matter, the other party said on the phone, "this matter is inconvenient for us to answer, I contact the relevant departments to talk about it." According to the internal staff of Dongtai people's Hospital, the hospital did have a hemodialysis patient infected with hepatitis C some time ago. At present, the entry of President Yin Weiguo can not be found in the column of "hospital leaders" on the hospital's official website.
Hepatitis C is an acute and chronic hepatitis caused by hepatitis C virus (HCV). It is mainly transmitted by blood, sex and mother to child. Hepatitis C is not known until compared with hepatitis A and hepatitis B. China did not confirm the existence of hepatitis C virus until 1989. After hepatitis C virus infection, the symptoms of patients are mild or asymptomatic, but the chronic rate is as high as 60% ~ 85%. It is easy to develop into chronic hepatitis C patients, and then develop into cirrhosis.
Hemodialysis patients are considered as high risk group of HCV infection because of sharing dialysis equipment and close contact. Some scholars conducted a retrospective analysis of the domestic outbreaks of hepatitis C infection from 1996 to 2016, and found that 10 of the 17 outbreaks were due to hemodialysis.
In the past, hepatitis C was mainly transmitted through blood transfusion and donation. Since 1993, the number of patients infected with hepatitis C through blood transfusion has decreased significantly in China In the prevention and control of hepatitis C, blood transfusion transmission has been significantly reduced in recent years, so the focus is on unsafe injection and other iatrogenic transmission. " Cai Haodong, chief physician of Beijing Ditan Hospital, who has been engaged in clinical work of infectious diseases for more than 30 years, once pointed out in an interview with the media, "the iatrogenic transmission is not completely uncontrollable. For example, renal dialysis is much better after strict rectification. As long as the rules and regulations are formally implemented, the spread of disease can be greatly reduced. "
The incidence of nosocomial hepatitis C infection in hemodialysis patients has also occurred before. From 2009 to 2011, a number of primary hospitals in Shanxi, Anhui, Henan, Liaoning and other places were exposed that hemodialysis patients were infected with hepatitis C. The investigation reports of several cases of hepatitis C infection in hemodialysis patients all pointed out that there were loopholes in the management of hemodialysis in these hospitals, or medical devices such as catheters were used repeatedly, or the operation process was not standardized, which led to the prevalence of hepatitis C in the hospital.
Taking the hepatitis C infection of hemodialysis patients in Zhen'an County Hospital of Shangluo City in Shaanxi Province in 2016 as an example, 39 of 78 hemodialysis patients with suspected exposure to HVC were diagnosed with hepatitis C. The investigation results of the incident published by Cao Lei, the doctor in charge of Shaanxi CDC, and others in 2018 showed that the main reasons for the outbreak were that the hemodialysis room of the hospital did not implement isolated dialysis for patients with hepatitis B and hepatitis C, many people shared heparin syringes, and some dialyzers were reused, and the disinfection procedures were not standardized.
In order to reduce the risk of nosocomial infection, in 2010, the Ministry of Health issued the "management standard for hemodialysis rooms of medical institutions". Patients requiring hepatitis B, hepatitis C virus, Treponema pallidum and HIV should be treated in their isolated dialysis treatment rooms or isolated dialysis treatment areas for special hemodialysis, treatment rooms or treatment areas. Hemodialysis machines should not be mixed with each other.