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UK Hepatitis C Look Back Exercise

Statement from Public Health England:

Public Health England (PHE) is aware that a healthcare worker who had worked in Obstetrics and Gynaecology has been diagnosed with Hepatitis C infection. It has recently come to light that the healthcare worker is known to have transmitted the virus to two patients while working at a hospital in Wales from 1984 until they ceased clinical practice in 2002.

A ‘lookback’ patient notification exercise involving the review at least 3,000 former hospital patients’ notes and records from the Caerphilly District Miners Hospital has been announced by the Aneurin Bevan Health Board today. Around 200 former hospital patients from two other hospitals in Wales where the healthcare worker practised for a short time are also being contacted.

Those patients identified as exposed or possibly exposed to Hepatitis C are being sent individual letters and asked to call a special confidential helpline, inviting them to attend a hospital clinic or, if they have moved away from the area, their GP for a blood test. Effective treatments are available for Hepatitis C and further information and advice will also be provided to anyone who needs it.

There is only a small chance that a patient might acquire Hepatitis C virus infection through surgical contact with an infected healthcare worker. The risk is very low as this can only occur if the healthcare worker is infectious and leads or assists in an operation or procedure on the patient. However, even in such circumstances transmission is very rare.

The healthcare worker also worked at other hospitals across the UK prior to working in Wales, including 11 hospitals* in England between 1975 and 1983. Similar look back exercises are taking place in parallel across all the hospitals in England, Scotland and Northern Ireland where the healthcare worker practised.

Less than 400 women in England have so far been identified as having definitely or possibly had operations conducted by the affected healthcare worker. They will be contacted directly by letter inviting them to call a confidential helpline,to discuss whether they would like to have a blood test arranged at their GP practice.

As it has been almost 30 years since the individual worked in hospitals in England, records of women who may be at risk are in some cases incomplete, for example if the hospital has been renamed or patients have moved around the country.

In England, the helpline and support service (0800 121 4400) will also be in place from Thursday 12 September, for any woman who is concerned because they had an obstetric or gynaecological operation, or they gave birth, at one of the 11 hospitals during the specified periods.

Dr Paul Cosford, medical director at PHE, said: “We have worked hard to identify women in England who might have been at risk of contracting infection with hepatitis C from this healthcare worker and are contacting them to offer advice and a blood test for hepatitis C, should they wish to have one. I want to emphasise that the risk of infection is very small and that we are offering them testing purely as a precaution.

“Around one in 250 adults in England have chronic Hepatitis C infection and it does not automatically lead to health problems. Treatment can help clear the infection in up to 80 per cent cases, which is why it’s important to identify anyone who may be at risk of having been infected so treatment can be started if necessary”.

Like most people who are infected with hepatitis C, the healthcare worker had no symptoms and was unaware of the infection until after they retired. As soon as the risk of infection was recognised, and a transmission was confirmed, a process of tracing their occupational history began.

Since 2007, all healthcare workers who are new to the NHS are tested for hepatitis C by their employing Trust, including anyone performing certain procedures (known as Exposure Prone Procedures). Existing NHS healthcare workers performing Exposure Prone Procedures for the first time are also tested for hepatitis C.

Public Health England Press Release

Public Health Wales Press Release

Public Health Scotland

Public Health Northern Ireland

The Hepatitis C Trust helpline information

The Hepatitis C Trust is a UK-wide organisation that provides support and information to people living with hepatitis C and those at risk of infection.

The Hepatitis C Trust runs a confidential helpline which can be called on 0845 223 4424 or 020 7089 622. It is open weekdays 10am-4:30pm, and is staffed solely by people with personal experience of living with hepatitis C.

For additional information please visit:

http://www.hepctrust.org.uk/Support/Services/Hepatitis+C+Trust+helpline

What is hepatitis C?

Hepatitis C is virus that is carried in the blood. It attacks the liver and if left untreated can cause cirrhosis and liver cancer. It is treatable and curable.

Estimates suggest that 216,000 people have hepatitis C in the UK, but only half have been diagnosed. Many people with the virus don’t realise they have it as often they won’t have any obvious symptoms.

There is no vaccine but treatment can successfully clear hepatitis C in the majority of cases. New drug treatments are on the horizon that will improve success rates even further.

Risk factors:

The virus is spread by contact between the blood of a person with hepatitis C going into the bloodstream of another person. The most common ways of contracting hepatitis C are:

  • Breaking the skin with unsterilised equipment or needles
  • Receiving a blood transfusion or blood product in the UK before 1991
  • Current or past intravenous drug use or sharing any injecting or snorting equipment
  • Blood transfusions or medical and dental procedures in a developing country
  • Tattoos, piercings or acupuncture in unregistered premises using unsterilised equipment
  • The transmission rate from mother to child during pregnancy is about 6%*
  • Heterosexual sex between monogamous couples is not considered a risk. Men who have sex with men are at a higher risk of contracting hepatitis C
  • Sharing razors or toothbrushes with a person who is known to have hepatitis C is a low transmission risk

* Nash KL, Bentley I, Hirschfield GM; Managing hepatitis C virus infection. BMJ. 2009 Jun 26

Testing:

A simple blood test will indicate whether or not a person has been exposed to the virus. If you feel you have ever been at risk, get tested. Speak to your GP or for a confidential test visit your local sexual health clinic.