Patient-To-Patient HCV Transmission Traced To Colonoscopy


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WESTPORT, Jul 24 '97 (Reuters) - French investigators believe that colonoscopy was the route of hepatitis C transmission from one patient who was HCV positive to two other patients who underwent colonoscopy on the same day in the same unit.

Dr. Jean-Pierre Bronowicki and associates from the Centre Hospitalier Universitaire de Nancy in Vandoeuvre, France, describe their investigation into the cases in the July 24 issue of The New England Journal of Medicine. "The timing of the events and the molecular characterization of the various HCV isolates provide evidence that HCV was transmitted during colonoscopy," the investigators write.

They believe that the lack of use of two currently recommended endoscope disinfection procedures could have resulted in HCV being transmitted: the biopsy-suction channel of the endoscope was not cleaned with a brush and the biopsy forceps and the diathermic loop were not autoclaved following each use.

"Inadequate" procedures to avoid contamination via anesthesia equipment may also have led to HCV transmission, the investigators say. While the IV tubing and "...all the syringes containing the anesthetic drugs were changed after the first colonoscopy, in which the patient...was known to be HCV-positive," records show that "...inadequate procedures were followed during the other two procedures."

N Engl J Med 1997;337:237-240.

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