Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-26T07:16:09.708Z Has data issue: false hasContentIssue false
  • English
  • Français

A Nosocomial Outbreak of Malaria Associated With Contaminated Catheters and Contrast Medium of a Computed Tomographic Scanner

Published online by Cambridge University Press:  02 January 2015

Kow-Tong Chen ,
Chein-Jen Chen ,
Po-Ya Chang  and
Dale L. Morse
Kow-Tong Chen*
Affiliation:
Graduate Institute of Life Sciences, National Defense Medical Center and Field Epidemiology Training Program, National Institute of Preventive Medicine, Taipei, Taiwan, Republic of China
Chein-Jen Chen
Affiliation:
Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China
Po-Ya Chang
Affiliation:
Department of Health, Executive Yuan, Taipei, TaiwanRepublic of China
Dale L. Morse
Affiliation:
Division of Infectious Disease, Wadsworth Center, New York State Department of Health, Albany, New York
*
Field Epidemiology Training Program, National Institute of Preventive Medicine, Department of Health, No. 6-8F, Lin-Shen South Rd, Taipei, Taiwan, ROC
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To identify the risk factors associated with an unexpected outbreak of malaria that occurred among seven patients in a general teaching hospital in Taipei in October 1995.

Design:

A three-stage case-control study was conducted to identify risk factors.

Patients:

We identified all 7 patients who were diagnosed as malaria cases and 69 controls from those undergoing computed tomography (CT) examination.

Methods:

Malaria was diagnosed by demonstrating the presence of Plasmodium falciparum on either thick or thin blood smears. Clinical characteristics and exposure information were collected from medical records and patient interviews.

Results:

The index case was infected by malaria when he visited Nigeria in early September and was diagnosed when he was hospitalized in hospital A in October. Among 10 patients examined with the Imatron scanner after the index case, all 6 who were injected with contrast medium were infected, but none of 4 examined without contrast medium were infected (P=.005).

Conclusions:

This nosocomial outbreak of malaria was most likely due to transmission via a contaminated catheter and contrast medium used for CT scanning. Use of disposable catheters may avoid such nosocomial outbreaks in the future.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 1 , January 1999 , pp. 22 - 25
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Centers for Disease Control and Prevention. Malaria surveillance— United States, 1993. MMWR 1997;46(SS-5):1–18.Google Scholar
2. Glynn, JR. Infecting dose and severity of malaria: a literature review of induced malaria. Journal of Tropical Medicine and Hygiene 1994;97:300–316.Google ScholarPubMed
3. Department of Health, Republic of China. Cases of notifiable and reportable diseases, Taiwan area. Epidemiology Bulletin 1995;11:195–198.Google Scholar
4. Mpofu, SM. Seasonal vector density and disease incidence patterns of malaria in an area of Zimbabwe. Trans R Soc Trop Med Hyg 1985;79:169–175.CrossRefGoogle Scholar
5. Fulton, JD. The metabolism of malaria parasites. Br Med Bull 1951;8:22–27.Google Scholar
6. Shute, PG. Mosquito infection in artificially induced malaria. Br Med Bull 1951;8:S56–S63.Google Scholar
7. Most, H. Malignant malaria among drug addicts. Trans R Soc Trop Med Hyg 1940;4:139–172.CrossRefGoogle Scholar
8. Shute, PG, Maryon, M. A study on the infectivity of patients to mosquitoes in the early stages of primary Plasmodium vivax malaria. Trans R Soc Trop Med Hyg 1957;51:403–410.Google Scholar
9. Biggam, AG. Malignant malaria associated with the administration of heroin intravenously. Trans R Soc Trop Med Hyg 1929;23:147–155.Google Scholar
10. Garcia, JJG, Amalich, F, Pena, JM, et al. An outbreak of Plasmodium vivax malaria among heroin users in Spain. Trans R Soc Trop Med Hyg 1986;80:549–552.Google Scholar
11. Lettau, LA. Nosocomial transmission and infection control aspects of parasitic and ectoparasitic diseases, part II: blood and tissue parasites. Infect Control Hosp Epidemiol 1991;12:111–121.Google Scholar
12. Mortimer, PP. Nosocomial malaria. Lancet 1997;349:574.Google Scholar
13. Navarro, P, Betancurt, A, Paublini, H, Medina, I, Nunez, MJ, Dominguez, M. Malaria causada por Plasmodium falciparum corno infection nosocomial. Bol Oficina Sanit Panam 1987;102:476–482.Google Scholar
14. Abulrahi, HA, Bohlega, ET, Fontaine, RE, Al-Seghayer, SM, Al-Ruwais, AA Plasmodium falciparum malaria transmitted in hospital through heparin locks. Lancet 1997;349:23–25.Google Scholar
15. Rosenberg, R, Wirtz, RA, Schneider, I, Burge, R. An estimation of the number of malaria sporozoites ejected by a feeding mosquito. Trans R Soc Trop Med Hyg 1990;84:209–212.CrossRefGoogle ScholarPubMed
16. James, SP, Nicol, WD, Shute, PG. Clinical and parasitological observations on induced malaria. Proceedings of the Royal Society of Medicine 1936;24:879–894.CrossRefGoogle Scholar
17. Glynn, JR, Collins, WE, Jeffery, GM, Bradley, DY. Infecting dose and severity of falciparum malaria. Trans R Soc Trop Med Hyg 1995;89:281–283.CrossRefGoogle ScholarPubMed
18. Glynn, JR, Bradley, DJ. Inoculum size, incubation period and severity of malaria: analysis of data from malaria therapy records. Parasitology 1995;110:7–19.Google Scholar
19. Hamilton, FN. Sidelight on malaria in man obtained by subinoculation experiments. Trans R Soc Trop Med Hyg 1947;40:621–676.CrossRefGoogle Scholar
20. Wirth, DF, Rogers, WO, Barker, R JR, Dourado, H, Suesebang, L, Albuquerque, B. Leishmaniasis and malaria: new tools for epidemiologic analysis. Science 1986;234:975–979.Google Scholar
21. Froude, JRL, Weiss, LM, Tanowitz, HB, Wittner, M. Imported malaria in the Bronx: review of 51 cases recorded from 1986 to 1991. Clin Infect Dis 1992;15:774–780.Google Scholar
22. Warsame, M, Wernsdorfer, WH, Huldt, G, Bjorkman, A. An epidemic of Plasmodium falciparum malaria in Baicad, Somalia, and its causation. Trans R Soc Trop Med Hyg 1995;89:142–145.Google Scholar
23. Marsh, K. Malaria—a neglected disease? Parasitology 1992;104:S53–S69.Google Scholar
24. Fruggatt, JW, Dwyer, DM, Stephens, MA. Hospital outbreaks of hepatitis B in patients undergoing electroconvulsive therapy. In: Program and abstracts of the 31st ICAAC; 1991; Chicago, IL. Abstract 347.Google Scholar