spread in Romania due to nurses' practices
Hepatitis spread in Romania due to nurses' practices
By Emma Patten-Hitt
ATLANTA, Feb 05 (Reuters Health) - Romanian nurses' failure to use proper
injection and infection-control techniques could explain many cases of
hepatitis B virus (HBV) infection among young children in that country,
according to the Centers for Disease Control and Prevention in Atlanta,
After HIV spread among children in Romanian orphanages in the early 1990s
due to the reuse of syringes, healthcare workers in that country began
using disposable syringes to give injections. By 1998, the CDC notes, most
adult Romanians knew that HIV could be spread by reusing syringes and
But according to the report published in the February 2nd issue of the
CDC's Morbidity and Mortality Weekly Report, many are not aware that HBV
infection, which is common in Romania, can be spread in the same fashion.
Hepatitis B is a liver-infecting virus that can be transmitted sexually, in
contaminated blood products and by reusing syringes and needles. The
infection can cause complications of the liver and may lead to liver
failure and even death.
"Virtually all the nurses and the public that we talked to were completely
aware of the association between HIV and reuse of needles and syringes, but
they weren't as aware of how HBV can be transmitted," Catherine Dentinger
of the CDC told Reuters Health.
Health officials surveyed 180 nurses in VĂ¢lcea, Romania, in 1998, after
observing that acute HBV infection among children younger than 5 was
associated with having received injections.
Although 99% of the nurses knew about universal precautions designed to
prevent transmission of infection by viruses and bacteria carried in the
blood, 62% didn't know that--unlike HIV--HBV remains infectious in the
environment for up to 1 week.
The majority of nurses also did not know that "the risk for transmitting
HBV through injections can be up to 100 times greater than the risk for
transmitting HIV," the report indicates. Only 4% of the nurses were aware
that following a needlestick, they were more likely to develop HBV
infection than HIV infection.
The nurses also reported shortages of infection-control supplies, such as
gloves and containers for used needles, as well as inadequate infection
"This same problem does not exist in the US," Dentinger noted. "We don't
have a shortage of infection-control supplies and the prevalence of HBV is
low, so there's theoretically no risk of transmission of HBV this way."
In 1999, CDC and Romanian health officials compiled recommendations to
improve injection safety, and have launched a campaign to inform healthcare
workers and the public about these recommendations.
"We want to address this problem globally, not just in Romania," Dentinger
said. "We want to try to reduce risks associated with injection as much as
possible," she added, "but we are pleased with the success of efforts to
stop needle reuse."
SOURCE: Morbidity and Mortality Weekly Report 2001;50:59-61.
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