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Possible West Nile Virus Dialysis Case

CDC Investigates Possible Transmission at Clinic in Georgia.
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Aug. 19, 2004 -- The Centers for Disease Control says that West Nile disease may have been transmitted at a dialysis clinic in Georgia.

The clinic and county are not named in the CDC's report. Three people received dialysis at the same clinic with the same machine on the same day in late August 2003.

Two people were confirmed to have West Nile disease, and one died. The third person was not confirmed to have West Nile virus. Based on records from the clinic, this person received dialysis on the same machine during the time between the two confirmed cases.

The CDC report says that Georgia public health officials learned about the cases in October 2003.

The two confirmed cases of West Nile virus disease were the only people in their county to have been confirmed with the illness in 2003, according to the CDC.

The first dialysis patient, a 77-year-old man with high blood pressure and kidney failure, was hospitalized eight days after dialysis for symptoms including fever, chills, and confusion. He was confirmed to have West Nile disease and was released from hospital nine days later. They say the patient had not received a blood transfusion within 30 days of his symptoms. West Nile virus transmission has been reported through blood transfusion.

The second patient who received dialysis was a 71-year-old woman with type 2 diabetes, high blood pressure, and kidney failure who did not become ill. Blood tests done on this woman did not show her to have West Nile virus disease.

The third and last person to receive dialysis on this machine that day was a 60-year-old man with type 2 diabetes, high blood pressure, kidney failure, alcoholism, and prostate cancer.

Nineteen days after receiving dialysis, he was admitted to a local hospital with symptoms including fever and chills. After being hospitalized, he had seizures and was placed on a respirator machine.

He tested positive for West Nile disease. Twenty days after admission, he died after having a high fever and respiratory failure.

"Patients on dialysis are highly susceptible to infections because they are often immunocompromised (have weakened immune systems) and exposed routinely to invasive techniques and devices," states the CDC.

"The possibility that West Nile virus might be transmitted during dialysis underscores the necessity for dialysis facilities to strictly adhere to proper infection-control procedures at all times," the CDC report concludes.

According to the CDC's report, the local health department investigated practices and procedures at the clinic and found no breakdown in infection control procedures.

An editorial note that follows the CDC's report states that the evidence in the investigation was inconclusive in determining a source of infection.

SOURCE:Centers for Disease Control.

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