Australians investigate hepatitis C cases

BMJ 1994; 308 doi: (Published 14 May 1994) Cite this as: BMJ 1994;308:1256
  1. C Zinn

    Infection control procedures in Australia are under renewed scrutiny as health authorities investigate the possibility that patient to patient transfer of hepatitis C may occur. The New South Wales (NSW) health department fears that five patients contracted the disease after visiting a private hospital in Sydney on the same day in January last year. Federal health minister Carmen Lawrence has warned that the government could intervene to ensure that hospitals follow the strict guidelines laid down to avoid infection. A national review of the guidelines was recently carried out after reports late last year of the first recorded case of patient to patient transmission of HIV. Four women became infected after undergoing minor surgery at a doctor's rooms in Sydney on the same day. One patient has already died of an AIDS related illness.

    In the hepatitis cases investigations are proceeding, but the health department has found that there was no common use of equipment, such as scalpels. Dr George Rubin, the NSW health department's director of epidemiology, said that two patients developed acute hepatitis C last year, several months after having surgery at the Macarthur private hospital on the same day.

    The hospital did not notify the health department but conducted its own investigations. “There was a strong belief that the two cases were a coincidence. There was not great urgency,” said Dr Barry Catchlove, managing director of Health Care of Australia, which owns the hospital. Then tests identified three other patients with the disease among 49 people who had had surgery at the hospital on the same day, the day before, or the day after. The only common factor in all five cases was that the patients had received an anaesthetic.

    The New South Wales opposition health spokesman, Dr Andrew Refshauge, said that cutbacks in state health budgets meant that hospitals were not employing the best infection control procedures.

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