10/20/10 — Four seniors die of hepatitis B

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Four seniors die of hepatitis B

By Phyllis Moore
Published in News on October 20, 2010 1:46 PM

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Officials at GlenCare of Mount Olive are trying to determine the cause of a hepatitis B outbreak that has left four residents dead over the past several months.

MOUNT OLIVE -- The deaths of four residents, all senior citizens, at GlenCare assisted living facility in Mount Olive have prompted an investigation into patient safety practices by the Wayne County Health Department and the state's Division of Public Health.

The state announced Tuesday that five residents have tested positive for hepatitis B virus since late August. The deaths occurred over the span of about three months in a random pattern, health officials said.

Officials at GlenCare said they are cooperating with the investigation, including whether the infection was acquired at the facility or elsewhere.

Residents at the facility are being tested and notification letters have been sent to residents and family members regarding the outbreak. Public health officials have also recommended that all residents there be vaccinated to prevent future infection of hepatitis B.

Hepatitis B is a blood-borne disease that can cause liver problems. It is typically transmitted by exposure to blood or body fluids. State and local health personnel have been at the facility to determine the cause of the infections and to ensure the safety of other residents.

"We have got a very good hospital staff that recognized the fact that we had something going on over there, and communicable disease staff that recognized that we had a hepatitis B outbreak," James Roosen, health director, said Tuesday afternoon. "That's not really easy because the incubation period for that disease covers a long time -- it could be anywhere from one month to six months.

"About 1 out of 250 people in the U.S. have the virus, but not everybody gets sick. Maybe until they're infected by something else, like HIV or a severe flu ... the elderly are also more susceptible."

While the exact cause of the outbreak is still unknown, Roosen said it could be "just a common error" that often occurs in places where blood is drawn or shots are given.

"It does happen," he said. "Unfortunately, there are outbreaks and cross contamination which occur, which may be what's occurring now."

The state reportedly learned of the possible cluster of cases last week, notifying operators of adult care homes of guidelines from the federal Centers for Medicare and Medicaid Services and the Centers for Disease Control and Prevention regarding appropriate infection control procedures.

"We are working with facility staff to ensure that any residents or staff who may have been exposed receive proper care and to prevent any further spread of the virus," said Dr. Jeff Engel, state health director. "Based on our experience in similar settings, we believe the illnesses may be associated with health care delivery, but are also investigating other possibilities. This should be a reminder for other long-term care facilities to review their infection control practices and make sure they're doing everything they can to protect residents from infection."

GlenCare officials issued a written statement, indicating they are cooperating with the investigation.

"Although the chance of exposure is small, we want to take every precaution," the release said. "The patients who have tested positive have several common factors regarding health care agencies. We understand from the state health department that cases have occurred in skilled facilities in the past where more invasive blood contact is expected than it would be in adult care homes such as GlenCare. We have limited blood contact in this facility with the exception of finger sticks for blood sugar readings. We have used individual pin sticks and individual glucometers for almost two years now, which is more stringent than the federal requirements.

"In conjunction with the health department, we are looking into our procedure to assure that cross contamination is not occurring."

According to the state Division of Health Service Regulation, there have been several complaints or violations filed in the county against GlenCare. Jim Jones, public information officer, said that each was investigated but found to be unsubstantiated.

"On the surface it looks like they haven't had any severe problems," he said.

At its most recent annual inspection, April 12, the facility received a three-star rating. Adult care facilities can earn up to four stars, Jones said.

The facility remains open, but a spokesperson said this morning that visitors are limited to family members only.