An Outbreak of Hepatitis C Virus at a Renal Dialysis Unit: A Lesson From a War Zone

摘要: In patients on regular hemodialysis, Hepatitis C virus (HCV) is considered the most important infectious disease transmitted by parenteral route. Such an infection may predispose patient to serious consequences such as cirrhosis and hepatocellular carcinoma. The prevalence of HCV antibody positivity in hemodialysis varies markedly from 5% industrialized countries up 54% some developing (1). Duhok Iraqi city Kurdistan region, northern Iraq. hosts 744 685 internally displaced persons 109 352 registered Syrian refugees. Additionally, thousands unregistered refugees main destination for Syrians after war. renal dialysis center serving people living this city. Due war circumstances, three types visit center: visitors, emergency with unsettled addresses, who are mainly persons. All screened HCV, a monthly basis. studies conducted neighboring Iran, Turkey Saudi Arabia, it was found that 4%, 29% 20%, respectively (2, 3). Europe, ranges 2% UK around 20% Spain Italy (3-5). We followed 99 during year 2015 starting January December AB testing enzyme-linked Immunosorbent assay (ELISA). At beginning our study, two (2%) were antibody-positive both sent polymerase chain reaction (PCR) confirm current infection. virus-real time (HCV-RTPCR) showed positive results patients. This rate less than what regional (6, 7) but higher general population (8, 9). During course new cases diagnosed HCV. October 2015, samples (two males one female) HCV-AB positivity. tests repeated again then, these confirmed RTPCR. newlydiagnosed interviewed they denied all risk factors transmission previous six months. Recalling used same unit, concluded acquired dialysis. other negative However, there missing due absence fixed address. No more detected subsequent A thorough investigation carried out discover causes outbreak. It noticed number sessions substantially increased 627 per month before 1335 arrival duplication session’s have put staff sterilization under pressure finishing soon possible meet increasing demands machines. burden thriving health system region. Urgent help needed international community stabilize prevent spread diseases especially communicable diseases. Collapse services region infections change map worldwide, use transient point travel Europe parts world.