Purpose
Once a hepatitis B virus (HBV) or hepatitis C virus (HCV) infection has been verified, this page outlines the proper corresponding steps to take in investigating an outbreak in a health care setting, including determining if the infection is due to exposure and tracking the investigation.
Step two: Determine potential exposure
Using information from step one, weigh the likelihood that the infection is due to health care exposure vs. other factors. For example, a remote history of an STD, incarceration, or injection drug use would not necessarily exclude a relevant health care exposure occurring during the likely exposure period.
Examples that are concerning for health care transmission and deserve thorough investigation include diagnosis of acute hepatitis B or hepatitis C (or documented seroconversion) occurring in a:
- Cancer patient
- Hemodialysis patient
- Transplant patient
- Long-term care resident, a
- Child without household members
- Routine blood donor.
Step three: Track the investigation
Health departments should consider entering relevant information into an electronic database whether they decide to pursue investigation of health care exposure or not. It will be important to have documentation if in the future you identify and report additional cases with overlapping health care exposures.
To help identify future patterns, capture the following information in the investigation database:
- Facility/provider names
- Date of investigation
- Disease
- County
- Lead investigator
- Identity of case being investigated
- Status of investigation