The Haliburton, Kawartha, Pine Ridge (HKPR) District Health Unit has concluded its investigation into the potential exposure to bloodborne viruses of patients of a Lindsay dental clinic.
Other than the original 2018 case that prompted the investigation and one subsequent case, the health unit advises no new cases of hepatitis C, hepatitis B, or human immunodeficiency virus (HIV) have been identified after extensive testing.
In May 2018, the HKPR District Health Unit alerted patients of Lakeland Clinic in Lindsay that they may be at risk for hepatitis B, hepatitis C, and HIV.
The warning came after the health unit determined there were times during which the proper sterilization of equipment may not have happened at the dental clinic. When sterilization is not done properly, there is a risk that clients can be exposed to other people’s germs on improperly cleaned instruments.
The investigation of the dental clinic started after the health unit was notified of a dental clinic patient who had been recently diagnosed with hepatitis C, with a strain or genotype not commonly seen in Canada. During its investigation, the health unit found a second patient, who had previously been diagnosed with hepatitis C with the same uncommon genotype, had received treatment at the same dental clinic on the same day just prior to the newly diagnosed case.
These two linked cases, and the discovery that proper sterilization of equipment may not have always happened at the clinic, prompted the health unit to send letters to patients of the clinic. Based on its investigation, the Health Unit wanted people who received treatment at the dental clinic between November 10, 2017 and February 21, 2018 to be tested for the three bloodborne viruses.
Of the 257 patient notification letters sent out by the health unit, 223 patients (87 per cent) had their blood tested. As there is a long incubation period for hepatitis C, the health unit sent out 167 additional letters urging patients to have follow-up blood testing done. Of those 167 patients, 92 (55 per cent) had tests completed.
There were no additional newly positive cases of hepatitis C, hepatitis B, or HIV identified as a result of this testing.
“We are extremely grateful to all of the patients who had blood tests completed as part of this investigation and very happy to see no additional infections,” says Dr. Lynn Noseworthy, Medical Officer of Health for the HKPR District Health Unit.
Many people who are infected with Hep C do not have symptoms and may not realize they are ill. Dr. Noseworthy continues to urge anyone who received a letter but did not get tested to consult with their health care provider and consider future testing. This testing and diagnosis will help ensure those who may be infected get the treatment they need and help ensure they do not unknowingly infect anyone else.
In this investigation, Dr. Noseworthy says she has nothing but praise for the co-operation provided by the Lakeland Clinic. The owner and staff worked with the health unit to quickly correct any infection prevention and control lapses identified and provided all the information required to contact the patients treated in the identified time period.
In 2015, the Ontario Public Health Standards were changed so that public health is required to follow up on infection prevention and control complaints and cases of reportable diseases in any public setting defined in the protocol, including those run by regulated health professionals.
Public health is not mandated to routinely inspect offices and clinics run by regulated health professionals. In those settings, the college of the health professional regulates and sets the standards that are to be followed.