Source of hepatitis outbreak at assisted living center still unclear
Posted November 11, 2010 7:38 a.m. EST
Updated November 17, 2010 10:23 a.m. EST
Mount Olive, N.C. — Public health investigators haven't identified the source of a hepatitis B outbreak at a Wayne County assisted living center, but the facility's owner said Thursday that they are looking at a diabetes pen shared among residents as a possible culprit.
State health officials said Thursday that five residents of Glen Care of Mount Olive who have died since August had the disease. Three other residents have contracted the disease but have survived, officials said. The deceased ranged in age from 63 to 83.
Glen Care owner Glenn Kornegay said at a Thursday morning news conference that investigators with the state Division of Public Health informed his staff that five medical technicians had reused diabetes pens, a device used to check the blood-glucose levels of diabetic patients.
Hepatitis B is a contagious virus that can cause severe liver problems, and it is typically transmitted by exposure to blood or body fluids. Symptoms include fever, extreme fatigue, loss of appetite, vomiting, dark urine and yellowish skin.
Kornegay said all of the technicians have denied using a diabetes pen on more than one patient, and they have denied telling investigators that they did.
Jim Jones, a spokesman for the state Department of Health and Human Services, said investigators haven't shared their findings with Glen Care staff, although state regulators might have discussed some concerns with staffers. The findings are expected to be released in the coming days, Jones said.
Glen Care officials said they don't know how the hepatitis spread, but they defended their staff.
"We take this very seriously. We are heartbroken. We really are," said Anne Kornegay, a vice president of the firm that owns the assisted living center. "I know in my heart they have not deliberately done anything improper."
Medical technician Bryan Stroud said it was "common sense" not to use the same blood-glucose monitor for several patients. Sheila Ashford, another technician, said she's worked at Glen Care for 13 years and has never seen it done.
The Centers for Disease Control and Prevention recommends that glucose meters not be shared, and if they are, they should be cleaned and disinfected after each use.
"We can't fix what we don't know," Anne Kornegay said. "Whatever it is, whenever it's detected, we will fix it. A lot of times, it goes undetermined."
She and others suggested that residents could have spread the disease by sharing drinks or having sex.
"These people have a right to (have intimate relationships), and we will not interfere with them," said Betty Merritt, a nurse at Glen Care. "We encourage safe sex just like you do with your teenager. Of course, people are going to do what they want to do."
Public health officials have said seven of the eight people who contracted hepatitis had diabetes, and the state Division of Health Service Regulation issued a six-point corrective plan to Glen Care for infection control.
By Nov. 19, the facility must appoint a staff member to coordinate infection-control measures at the facility, provide staff training on proper procedures and have a registered nurse or pharmacist observe blood-glucose monitoring of patients at least once a week, according to the corrective plan.
Glen Care officials said they already have infection-control measures in place, but in response to the state's corrective plan, they said they now wash their medical instruments with a bleach solution instead of just soap and water.
The fifth death has not been definitively linked to hepatitis B, but it is consistent with other deaths in the outbreak, officials said.
Donnie Ballard said that his 72-year-old father-in-law was diagnosed with hepatitis B at Glen Care and was hospitalized after becoming disoriented and weak. His father-in-law died at the hospital last Friday, he said.
Ballard said that Glen Care never notified his family about the hepatitis outbreak or his father-in-law's illness. The family got the news from hospital doctors, he said.
All residents in the facility were tested for hepatitis B in October, health officials said, and Glen Care offered free vaccination shots to those who aren't immune to the virus.