The number of patients exposed to blood-borne infections during diabetes testing, glucose monitoring and insulin delivery in group settings is on the rise, according to the Centers for Disease Control & Prevention.
Misused equipment and improperly trained staff have forced thousands to undergo blood testing for HIV, hepatitis B and hepatitis C over the past decade, but an aging population and increasing rate of diabetes has the CDC concerned about an uptick in potential outbreaks.
Bad hospital practices were blamed in the most recent patient advisory, when more than 2,300 patients were potentially exposed to infectious disease at a Wisconsin hospital where a fingerstick blood glucose sampling pen wasn’t properly cleaned between uses.
"The Centers for Disease Control and Prevention (CDC) has become increasingly concerned about the risks for transmitting hepatitis B virus (HBV) and other infectious diseases during assisted blood glucose (blood sugar) monitoring and insulin administration," the CDC reported. "Reports of HBV (hepatitis B) infection outbreaks linked to diabetes care have been increasing."
The problem is of particular concern in long-term care facilities where patients often need help testing their glucose levels and injecting insulin.
"In the last 10 years, alone, there have been at least 15 outbreaks of HBV infection associated with providers failing to follow basic principles of infection control when assisting with blood glucose monitoring," according to the CDC’s site. "Due to under-reporting and under recognition of acute infection, the number of outbreaks due to unsafe diabetes care practices identified to date are likely an underestimate."
In 2010 dozens of health fair attendees in New Mexico were put at risk when a fingerstick device was reused. In 2009 more than 2,000 people were urged to undergo testing after individual insulin pens were used for multiple patients.
In the Wisconsin outbreak, patients were potentially exposed to HIV and other diseases over the course of five years when a nurse, who was a certified diabetic educator and who left her job two weeks ago, used a fingerstick pen on multiple patients. Her job was to train newly diagnosed diabetics on proper glucose monitoring and insulin injection, the Associated Press reported.
A hospital whistleblower reported the nurse for using a fingerstick pen meant for demonstration on inanimate objects on patients. She used a clean needle each time, but blood can backflow into the pen’s reservoir and contaminate the next person pricked by the pen.
No incidence of actual disease exposure were found as of Monday, according to the news wire.
"This is what we call infection control 101," CDC epidemiologist Joe Perz told the Milwaukee Wisconsin Journal Sentinel. "One of the most common myths is that contamination is limited to the needle. An insulin cartridge is a form of syringe. And a syringe and needle should be seen as a single device. One can contaminate the other."