For information about the MultiCare Good Samaritan Puyallup potential hepatitis C exposure, go to www.multicare.org/safety-alert.
For more information about our ongoing disease investigation, head to our Hepatitis C Test Results page.
Hepatitis C can cause contagious liver disease.
In some people, hepatitis C can lead to a serious, lifelong illness. Left untreated, hepatitis can lead to life-threatening complications.
How does someone get hepatitis C?
Hepatitis C spreads when blood from a person with the virus enters the body of an uninfected person. This can happen from:
- Sharing needles, syringes or other drug injection supplies.
- Needle stick injuries in health care settings.
Less often, a person can get hepatitis C through:
- Being born to a mom who has hepatitis C.
- Sharing items like razors or toothbrushes that may have contacted blood.
- Sex with a person who has hepatitis C.
Are you at risk for hepatitis C?
People born from 1945 to 1965 are five times more likely to have hepatitis C. If you were born between 1945 and 1965, talk to your doctor about getting tested.
Want more information?
Check out our Hepatitis C Infographic.
You can also click on the questions below to get answers to Frequently Asked Questions.
I heard something about hepatitis C in Pierce County. What's going on?Rates of hepatitis C have been increasing nationwide and locally over the past few years, so the Health Department has increased our monitoring of new hepatitis C infections in Pierce County.
Earlier this year, we learned of new hepatitis C infections in people without the usual risk factors. It appears they may have been exposed to the virus during a healthcare procedure, like an injection. We're helping healthcare providers improve their infection control procedures. And we're helping the people affected get testing and treatment.
At this time, we are focusing our efforts on people who receive a health notification from their provider that they need to be tested. But anyone with risk factors for hepatitis C should get tested.
Can I get hepatitis C in a healthcare setting?
Any procedure involving blood can possibly transmit hepatitis C or other bloodborne illnesses. Health care providers need to have careful infection control practices in place to protect patient health. Even receiving vitamin infusions, acupuncture or other shots can put you at risk. That's why practitioners need to take extra care to follow sterilization and infection control procedures to keep you safe.
Nationwide, the opioid epidemic has led to widespread drug abuse, among all ages of people in all walks of life. That includes healthcare workers. When healthcare workers have problems with drugs and addiction, it is possible that patients can be harmed. Patients can be exposed to blood borne pathogens when healthcare workers steal medications for their own use, by accidentally contaminating patient medications with blood or other substances, which can cause infections.
(New) How could it have spread?
While we may never know exactly how hepatitis C spread in this outbreak, we know hepatitis C can spread in hospital settings. Reusing medication vials, syringes, and tourniquets as well as needles and other injection and medical equipment intended for single use cause outbreaks of blood borne diseases. For example:
In 2008, a radiology technician in Florida infected five patients with hepatitis C. He injected himself with syringes meant for patients. He refilled the syringes afterwards and changed the needle. Though the needle was clean, the syringe was contaminated.
In 2015, a nurse in Texas infected four patients with hepatitis B or C. She believed it was safe to use the same syringe on multiple patients because she flushed their IV lines. Though the syringe never directly contacted patients, it was contaminated with the virus through the IV.
What are the symptoms of hepatitis C?
An infected person's symptoms may include vomiting, abdominal pain or yellow eyes or skin. But most people don't know they have hepatitis C until they're tested. When they first get infected, 70% of people with hepatitis C won't have symptoms.
Most people who get hepatitis C will carry the virus throughout their lifetime, if they do not receive treatment. About 20% of people who contract hepatitis C will clear the infection on their own, without treatment.
How do I know if I have hepatitis C?
You may or may not show symptoms if you have hepatitis C. That's why you should contact your healthcare provider right away if you have the risk factors. You are at greater risk of exposure to the virus if you:
- Use a needle, syringe, or lancet contaminated with blood containing hepatitis C virus.
- Use a personal care item (like a razor, nail clipper or toothbrush) contaminated with blood containing the virus.
- Your mom had hepatitis C when you were born.
- Had sex with a person who has hepatitis C.
People born between 1945 and 1965 are five times more likely to have hepatitis C. If you were born during this time, talk to your healthcare provider about getting tested.
People who are at risk of hepatitis C should get tested. Take the free online test to determine your risk.
Why are people born between 1945 and 1965 five times more likely to have hepatitis C?The national blood supply was not tested for hepatitis C prior to 1992. The healthcare field hasn't always used our current universal precautions to prevent the spread of bloodborne diseases. If someone used drugs once, decades ago, they may not remember.
How do I get tested for hepatitis C?Ask your healthcare provider about getting tested for hepatitis C. You can also find out your level of risk by taking a free online test.
If you received a letter stating that you were potentially exposed in a healthcare setting, you should be tested now and again in six months if the visit where you got the shot or IV infusion was within the last six months.
(New) What information does hepatitis C testing provide?
Tests provide only a snapshot of a person’s blood at the time of testing. They will not tell us how long a person may have had the disease or when the person was first infected. We use two different tests to look for hepatitis C.
The first test is for antibodies. When someone is exposed to the hepatitis C virus, they create antibodies to fight the infection. They continue to make them even after the virus is gone. A positive antibody shows the virus was there but doesn’t tell us when.
The second test looks for genetic material from the hepatitis C virus. This material is called RNA, and tells us the virus is still present. Comparing the types of RNA found in different patients can also tell us if the infections came from the same source.
About 25% of people fight off hepatitis C in the first six months of their infection—without any treatment. During that six months, the person will have RNA and could spread the virus. Once the virus clears, or once an infected person completes treatment, the virus is gone and the RNA test will be negative. So, even though a person has a negative RNA now, it does not mean they never had the virus.
The figure on the right shows how we use the two different tests to determine infection status.
What do I do if I find out I have hepatitis C?
The most important step is to get treatment. When left untreated, hepatitis C can cause serious health problems. New treatments are available that can cure hepatitis C for almost everyone. Talk with your healthcare provider to determine which treatment option is best for you.
If you test positive for hepatitis C, someone from the Health Department will work with you.
- It may be possible to determine how long you have been infected.
- Some people may have had hepatitis C for a long time but have never been tested before.
- Just because you have hepatitis C does not mean you got it from a healthcare procedure.
How is hepatitis C spread?
Hepatitis C spreads when blood containing the virus gets inside another person. Typically, this happens through injection drug use or sharing needles, syringes or lancets contaminated with blood containing hepatitis C. Other ways hepatitis C can spread:
- Use of personal care items (like a razor, nail clipper or toothbrush) contaminated with blood containing hepatitis C.
- Getting a tattoo or piercing with unsterilized needles or other equipment (professional shops are low risk).
- Sex with a person who has hepatitis C (although the risk of this is very low).
- Your mom had hepatitis C when you were born.
What danger am I in if I got exposed to hepatitis C?
It depends on the type of exposure. Sometimes we don't know which type of exposure transmitted the virus.
- Sharing or using sharp items, like syringes or needles, with more than one person is very high risk.
- Sharing drug use equipment, like needles, syringes, rinse water, cottons and cookers, is high risk.
- Sharing a personal care item, (like a razor, nail clipper, tweezer or toothbrush) is moderate risk.
- Having sex with someone who has hepatitis C is a lower risk.
- Being born to a woman with hepatitis C is a lower risk.
How likely am I to get hepatitis C if I got exposed to it in a healthcare setting? Is it easy to get hepatitis C from this type of exposure?It is very rare that we see transmission of hepatitis C in healthcare settings. Providers need to follow careful infection control practices to protect patient health and safety.
What is the treatment for hepatitis C?
A variety of treatments are available. The new treatments are much easier to take than the old medications.
- Treatment is pills, not shots.
- Typically, the duration of treatment is two-three months.
- Few side effects.
- More than 90% of people who complete the new treatment are cured.
I got exposed to the virus by a healthcare provider. Does my family need to worry? Should they get tested, too?No. Only people who receive a health notification from their provider need to be tested. Transmission between family members is very rare, unless family members have one of the other risks listed above.
I’m hearing people will have to continue to get hepatitis C retests. Is this true?
No. The hospital is doing RNA (ribonucleic acid) tests for hepatitis C on all patients who were notified they may have been exposed. If hepatitis C transmission happened, the RNA test will be positive three weeks after exposure. No one will need to be retested for hepatitis C as a result of this event. If they were seen in the Emergency Department at MultiCare Good Samaritan Hospital in Puyallup within 12 weeks of March 23 (last date of potential exposure risk), they will need one retest for hepatitis B. The test for hepatitis B was included only because we are testing for all blood borne pathogens. If disease transmission occurred, all hepatitis B tests will be positive 12 weeks after exposure. So most people will need no retesting.
In general, the only people who need to be retested on a regular basis are people who are actively using injection drugs or sharing the equipment commonly used during this activity.
When and in what circumstances does a patient need to retest?Retesting is based on a person’s exposure date. When exposed, an individual is considered acute for up to six months, and would require additional testing to rule out infection in that timeframe. Past six months, the body has either cleared the infection or converted to a chronic carrier.
Does anyone need to test for hepatitis C ongoing?Injection drug users who are currently using need frequent retesting. Because they are at high risk of hepatitis C exposure, if they continue to use, they should be tested throughout their lives.
Can a person can be positive for hep C, clear it from their body, then become re-infected later?Yes, if the same risk factors exist.
Is a person more susceptible to reinfection once he or she has tested positive at any point?No. However, if the person is a chronic carrier of the disease, he or she should be treated for the disease. Treatment can happen in the acute phase as well.
My notification letter said I should get tested for hepatitis B and HIV, too. Why do I need these other tests?This is a precaution. Standard medical practice requires testing for these additional bloodborne pathogens because they are spread the same way as hepatitis C, although HIV is harder to catch than hepatitis B or C.
Will I or my insurance have to pay for testing or, if needed, treatment?
If you receive a health notification that you need to be tested for possible hepatitis C exposure and your insurance does not cover it, you have options. Your provider may offer free testing. Check your notification letter, or give them a call to find out more. In some cases, the Health Department can also pay for testing to ensure you get the care you need. We also will work with anyone who tests positive to explore their options for treatment.
(Updated) What happened at the hospital? Aren't there steps to keep this from happening?
We recently learned that 12 people who were treated in a local emergency department in December, 2017 became infected with hepatitis C during their medical treatment. We believe the source of the infection was contaminated medicine, needle, syringe, or equipment used by a former healthcare worker who may have been taking some of these medications for personal use.
We are working the hospital, the Washington State Department of Health, and the Health Services Quality Administration to ensure safeguards are in place to prevent this from happening again. Unfortunately, drug addiction is a widespread problem in society, even among healthcare workers. We are fortunate we detected the problem now, and are working with the hospital to improve processes and ensure safe care.
(New) When did the exposed people visit the hospital ER?
Of the 12 genetically linked, positive hepatitis C cases:
- 11 patients are new infections who got treatment in the hospital’s emergency department in December.
- One patient was a known hepatitis C infection and got treatment in the emergency department in August and November.
So far, all of the new positive, genetically linked cases were seen in the ER in December. Certain practices can play a role. Or, an infectious person can pass on the virus when he or she has higher levels of virus in the body. We will continue to investigate all possibilities.
*The Health Department identified the first two cases in February. Testing confirmed six genetically linked cases in June, and four in July.
What will happen to the healthcare provider for exposing patients to hepatitis C?The healthcare worker no longer works in the hospital and has been reported to the authorities.
(New) Did you have reason to test other hospital employees?
In any investigation, we look at all possible exposure sources, and we follow where the information leads us. During the Good Samaritan Hospital investigation, the Health Department requested three people—all of whom were hospital employees in late 2017—to be tested for hepatitis C. All three were tested. The only caregiver who tested antibody positive for hepatitis C and gave intravenous injections to all confirmed hepatitis C cases is a nurse who no longer works at the hospital.
Should other members of the public be concerned about exposure from the incident?
Take the test to learn if you should be tested for hepatitis C because of other risk factors.
(New) You’ve announced probable numbers throughout. What happened to them?
Most probable cases have moved to the confirmed category. We are waiting for CDC testing results on one probable case to confirm a genetic link.