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進入《TAIPEI TIMES》CDC links hepatitis C cluster to clinic
Centers for Disease Control Director-General Philip Lo, center, speaks at news conference in Taipei yesterday. Photo: CNA
NOT UP TO CODE: An inspection found flawed injection practices, and inadequate sterilization of equipment and environment at the clinic, a disease specialist said
By Lee I-chia / Staff reporter
A cluster of 11 confirmed acute viral hepatitis C cases was traced to a clinic in New Taipei City, the Centers for Disease Control （CDC） said yesterday.
The clinic was on Tuesday ordered to suspend operations, and people who have received any injections at the clinic after July 1 last year are urged to get a free blood test at one of the city’s public health centers, it said.
CDC physician Lee Yen-yi （李彥儀） said the centers on Aug. 12 received a report from New Taipei City’s Banciao District （板橋） about two cases of acute hepatitis C from the same family — a woman in her 70s and her son, in his 50s — and instantly launched an investigation.
The centers on Aug. 17 confirmed that they had received intravenous nutrient injections multiple times at Antai Songhe Clinic （安泰淞鶴診所）, implying a potential cluster of infections, which prompted an expanded investigation, she said.
Another family member of the first two cases — a woman in her 40s who also received injections at the clinic — was diagnosed with acute hepatitis C on Monday last week, but two other family members tested negative, Lee said.
Of the 150 confirmed cases of acute hepatitis C in the city from last year, eight other people had received injections at the Antai Songhe Clinic, she said.
The onset of the symptoms of the 11 cases associated with the clinic — seven men and four women aged 40 to 80 — occurred between Jan. 29 and Aug. 18.
A viral nucleic acid sequence similarity of 99.7 to 100 percent was found among nine of the 11 cases, indicating an infection of the same viral strain and a high probability that they shared an infection source, she said.
CDC Director-General Philip Lo （羅一鈞） said that as the first onset date among the confirmed cases was Jan. 29, the local health department is contacting about 1,118 people who received an injection at the clinic between July 1 last year and Thursday last week.
The incubation period of the disease is six months.
The CDC and the New Taipei City Department of Health conducted an unannounced inspection of the clinic on Aug. 20, and another inspection with an infection control specialist on Wednesday last week.
Far Eastern Memorial Hospital infectious disease specialist Liao Chun-hsing （廖俊星）, who joined the inspection, said they found nine flaws in the injection practices and infection control of the clinic.
Those include failure to perform hand hygiene before and after patient contact, needles left inserted in the rubber stoppers of vials and IV fluid bags for repeated withdrawal, and lack of sealed containers for safe disposal of medical sharps, he said.
Prefilled syringes were found in the medication preparation area and non-treatment areas; medications, blood samples and personal items were all stored in the same refrigerator, Liao said, adding that there was inadequate routine sterilization of medical equipment and the environment.
New Taipei City Department of Health Deputy Director-General Ma Cheng-yea （馬景野） said the department on Thursday last week ordered the clinic to suspend injection services and fined it NT$300,000, in accordance with the Communicable Disease Control Act （傳染病防治法）.
Lo said that on Tuesday, all of the clinic’s services were suspended until it passes an inspection.
Ma said people who received injections at the clinic after July 1 last year would be notified about a free blood test to screen for HIV, hepatitis B and C, liver function and syphilis at any of the 29 public health centers in the city.
Those who received injections between April and last month would be asked to get a follow-up blood test after six months to confirm or rule out infection, he said, adding that the department would refer those who test positive to hospitals for treatment.
Oral antiviral treatments covered by the National Health Insurance for chronic and acute hepatitis C are very effective, so those who are contacted by the health department are urged to cooperate with testing and follow-up treatment, the CDC said.
新聞來源：TAIPEI TIMES
