An outbreak of hepatitis B virus infection among methamphetamine injectors: the role of sharing injection drug equipment

Vogt, Tara M.; Perz, Joseph F.; Houten, Clayton K. Van; Harrington, Robert D.; Hansuld, Tia; Bialek, Stephanie R.; Johnston, Robert; Bratlie, Rachel; Williams, Ian T.

doi:10.1111/j.1360-0443.2006.01407.x

Cited by 26 publications

(25 citation statements)

References 9 publications

(11 reference statements)

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“…Reportedly, the remainder of the fentanyl in the patient vials was then administered to patients using the same syringe that was used to make the transfer. This mechanism of transmission by indirect syringe reuse, involving accessing contaminated vials or containers, has been well-documented in other viral hepatitis outbreaks associated with healthcare and injection drug use 17,18 . Epidemiologic and laboratory evidence indicated that the CRNA became infected, sequentially, with two different strains of HCV from chronically infected patients and subsequently transmitted to susceptible patients.…”

Section: Resultsmentioning

confidence: 95%

Outbreaks of Infections Associated With Drug Diversion by US Health Care Personnel

Schaefer

Perz

2014

Mayo Clinic Proceedings

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Objectives To summarize available information about outbreaks of infections stemming from drug diversion in U.S. healthcare settings and describe recommended protocols and public health actions. Patients and Methods We reviewed records at the Centers for Disease Control and Prevention related to outbreaks of infections from drug diversion by healthcare personnel in U.S. healthcare settings from January 1, 2000, through December 31, 2013. Searches of the medical literature published during the same period were also conducted using PubMed. Information compiled included healthcare setting(s), infection type(s), specialty of the implicated professional, implicated medication(s), mechanism(s) of diversion, number of infected patients, number of patients with potential exposure to bloodborne pathogens, and resolution of the investigation. Results We identified six outbreaks over a ten year period beginning in 2004; all occurred in hospital settings. Implicated healthcare professionals included three technicians and three nurses; one of whom was a nurse anesthetist. The mechanism by which infections were spread was tampering with injectable controlled substances. Two outbreaks involved tampering with opioids administered via patient-controlled analgesia pumps and resulted in gram-negative bacteremia in 34 patients. The remaining four outbreaks involved tampering with syringes or vials containing fentanyl; hepatitis C virus (HCV) infection was transmitted to 84 patients. In each of these outbreaks the implicated healthcare professional was infected with HCV and served as the source; nearly 30,000 patients were potentially exposed to bloodborne pathogens and targeted for notification advising testing. Conclusions These outbreaks revealed gaps in prevention, detection, and response to drug diversion in U.S. healthcare facilities. Drug diversion is best prevented by healthcare facilities having strong narcotics security measures and active monitoring systems. Appropriate response includes assessment of harm to patients, consultation with public health officials when tampering with injectable medication is suspected, and prompt reporting to enforcement agencies.

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Section: Resultsmentioning

confidence: 95%

Outbreaks of Infections Associated With Drug Diversion by US Health Care Personnel

Schaefer

Perz

2014

Mayo Clinic Proceedings

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“…Injection of methamphetamine can lead to transmission of bloodborne pathogens when injection equipment is shared, as demonstrated in an outbreak of hepatitis B among methamphetamine users in Wyoming ( 27 ). A recent case series of 14 patients with MRSA necrotizing fasciitis found that 43% of the patients had current or past injection drug use ( 28 ).…”

Section: Discussionmentioning

confidence: 99%

Methamphetamine Use and Methicillin-ResistantStaphylococcus aureusSkin Infections

Cohen

Shuler

McAllister

et al. 2007

Emerg. Infect. Dis.

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“…Early sexual behavior and frequent unprotected sex among heterosexual and homosexual users of methamphetamine result in higher rates of Hepatitis and HIV infection rates (Davis, Kalousek, & Rubenstein, 1970; Gorman, 2003; Greenwell & Brecht, 2003; Harkess, Gildon, & Istre, 1989; Hutin et al, 2000; Koester, Glanz, & Barón, 2005; Meyer, 2003; Molitor, Truax, Ruiz, & Sun, 1998; Urbina & Jones, 2004; Vogt et al, 2006). Methamphetamine use interferes with the efficacy of HIV medications and treatment (Anonymous, 2004; Boddiger, 2005; Jernigan et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Behavioral and social correlates of methamphetamine use in a population-based sample of early and later adolescents

Embry¹,

Hankins

Biglan

et al. 2009

Addictive Behaviors

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This paper reports relationships between methamphetamine use and behaviors and social influences using data from a population-based survey of 8th- and 11th-grade students in Oregon for the 2001–2003 school years. We analyze methamphetamine use within a general problem behavior framework to identify malleable correlates of behavior for future prevention interventions. We specifically test two models of methamphetamine use employing logistic regression analysis: one comprised of behaviors and traits of the individual students and another focusing on peer and parental influences. This study finds adolescent methamphetamine use related to several problem behaviors. However, the specific problems vary by grade and are moderated by gender. Findings indicate the need for tailored interventions targeting gender/grade-specific behaviors or problems such as antisocial activities, risky sex, and depression, as well as social influences such as peers engaging in antisocial behaviors or using drugs and parents favoring drug use or poorly monitoring or setting limits for their children.

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An outbreak of hepatitis B virus infection among methamphetamine injectors: the role of sharing injection drug equipment

Cited by 26 publications

References 9 publications

Outbreaks of Infections Associated With Drug Diversion by US Health Care Personnel

Outbreaks of Infections Associated With Drug Diversion by US Health Care Personnel

Methamphetamine Use and Methicillin-ResistantStaphylococcus aureusSkin Infections

Behavioral and social correlates of methamphetamine use in a population-based sample of early and later adolescents

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