MMWR Summary for July 28, 2017

July 28, 2017

Progress Toward Elimination of Hepatitis C Virus Infection — Georgia, 2015–2016

CDC Media Relations

404-639-3286

Outbreak of Septic Arthritis Associated with Intra-Articular Injections at an Outpatient Practice — New Jersey, 2017

Donna Leusner Director of Communications

NJ Department of Health (609) 984-7160 donna.leusner@doh.nj.gov

CDC Grand Rounds: Addressing Health Disparities in Early Childhood

CDC Media Relations

404-639-3286

Progress Toward Elimination of Hepatitis C Virus Infection — Georgia, 2015–2016

CDC Media Relations
404-639-3286

The country of Georgia’s hepatitis C elimination program has shown that treatment availability alone is not enough. Eliminating hepatitis C requires a comprehensive approach that includes screening linked to care and curative treatment, high-quality diagnostics, surveillance, provision of services to high-risk and marginalized populations, and measures to prevent transmission. In April 2015, in collaboration with CDC and other partners, the country of Georgia embarked on the world’s first national program to eliminate hepatitis C infection. Georgia has had one of the highest hepatitis C prevalence rates in the world; more than 5 percent of the adult population (150,000 adults) is estimated to be living with the virus. The goal of the program was to reduce Georgia’s hepatitis C prevalence 90 percent by 2020. During the initial phase, the program provided free, curative hepatitis C treatment to infected people with advanced liver disease. In June 2016, the program expanded to offer treatment for everyone regardless of disease severity. By December 2016, 27,595 hepatitis C-infected people initiated treatment. Seventy-two percent completed treatment; 84 percent of those who completed treatment and were tested for hepatitis C RNA were cured. The Georgia model program provides valuable lessons for global hepatitis C elimination, including the key lesson that treatment availability alone is not enough.

Outbreak of Septic Arthritis Associated with Intra-Articular Injections at an Outpatient Practice — New Jersey, 2017

Donna Leusner
Director of Communications
NJ Department of Health
(609) 984-7160
donna.leusner@doh.nj.gov

The findings from this investigation highlight the need for better adherence to and oversight of basic infection prevention recommendations and sterile compounding standards in outpatient settings. All healthcare providers and administrators within healthcare facilities must ensure adherence to recommended infection prevention practices and manufacturer’s recommendations when handling injectable medications. In March 2017, an outbreak of 41 cases of septic arthritis associated with intra-articular injections occurred at a private outpatient practice in New Jersey. A public health investigation identified multiple breaches of recommended infection prevention practices during the preparation and administration of injectable medications. The breaches included poor hand hygiene and inappropriate use of pharmacy bulk packaged (PBP) products by the office staff. Single-use medications, including PBP products, typically lack antimicrobial preservatives and can become contaminated when handled inappropriately. Use of a PBP product as a multiple-dose container outside of required pharmacy conditions can contaminate the container and serve as a source of pathogens for multiple patients. No additional septic arthritis cases were identified after infection prevention recommendations were provided to the practice and implemented.

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