ArticlePloS one2019
Modeling suggests that microliter volumes of contaminated blood caused an outbreak of hepatitis C during computerized tomography.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Safety and Performance of OptiVantage, a CT Contrast Media Injector, in Multi-Patient Mode.Medical devices (Auckland, N.Z.) · 2025Trial
- Modeling Highlights the Challenge of Achieving and Maintaining Hepatitis C Virus Micro-Elimination Among People Who Inject Drugs.Open forum infectious diseases · 2026Article
- Radiography students' knowledge, attitude and practice relating to infection prevention and control in the use of contrast media injectors in computed tomography.Journal of medical radiation sciences · 2025Article
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- Theoretical modeling of hepatitis C acute infection in liver-humanized mice support pre-clinical assessment of candidate viruses for controlled-human-infection studies.Scientific reports · 2024Article
- Infection prevention and control in the medical imaging environment: a scoping review.Insights into imaging · 2023Article
- New hope for hepatitis C virus: Summary of global epidemiologic changes and novel innovations over 20 years.World journal of gastroenterology · 2021Review
- Modeling based response guided therapy in subjects with recent hepatitis C infection.Antiviral research · 2020Article
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- Article
Corrections and comments
- Erratum issued
Authors and funding
21 authors.
Funding
Abstract
BACKGROUND &
aimsAcute hepatitis C (AHC) is not frequently identified because patients are usually asymptomatic, although may be recognized after iatrogenic exposures such as needle stick injuries, medical injection, and acupuncture. We describe an outbreak of AHC among 12 patients who received IV saline flush from a single multi-dose vial after intravenous contrast administration for a computerized tomography (CT) scan. The last patient to receive IV contrast with saline flush from a multi-dose vial at the clinic on the previous day was known to have chronic HCV genotype 1b (termed potential source, PS). Here we sought to confirm (via genetic analysis) the source of infection and to predict the minimal contaminating level of IV saline flush needed to transmit infectious virus to all patients.
methodsIn order to confirm the source of infection, we sequenced the HCV E1E2 region in 7 CT patients, in PS, and in 2 control samples from unrelated patients also infected with HCV genotype 1b. A transmission probabilistic model was developed to predict the contamination volume of blood that would have been sufficient to transmit infectious virus to all patients.
resultsViral sequencing showed close clustering of the cases with the PS. The transmission probabilistic model predicted that contamination of the multi-dose saline vial with 0.6-8.7 microliters of blood would have been sufficient to transmit infectious virus to all patients.
conclusionAnalysis of this unique cohort provides a new understanding of HCV transmission with respect to contaminating volumes and viral titers.
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