Assisted Infection

Infection control problems during assisted monitoring of blood glucose at an assisted living facility in North Carolina resulted in an outbreak of hepatitis B virus infections in 2010. Among the 40 facility residents who were susceptible to infection from hepatitis B virus, eight residents developed acute infections, and six of those died from hepatitis complications. All eight infections were among the 15 residents who received assisted monitoring of blood glucose monitoring from facility staff; there were no infections among the 25 residents who did not receive assisted monitoring of blood glucose. The large number of deaths in this outbreak attracted intense statewide news media coverage. Questions from a reporter prompted a state legislator to work with state agencies and industry representatives to develop new infection control requirements for assisted living facilities and increased training requirements for the unlicensed staff who perform medical services. Just six months after the outbreak was identified, legislation to implement these new infection control requirements was passed by the North Carolina General Assembly with unanimous support, despite a typically cool reception to new regulation among the majority of legislators in both chambers. Although the high mortality rate in this outbreak is unusual, the infection control problem that resulted in this outbreak is not unique to North Carolina. At least 20 similar outbreaks at assisted living facilities have been reported to CDC since 2004. Through interviews with family members of the deceased, subject matter experts, policy makers, and others, this documentary aims to illustrate the impact of this outbreak and why the policy changes adopted in North Carolina should be emulated elsewhere.