Controlling Spread of Hepatitis C

Table of Contents

A. Isolation and Quarantine Requirements

Minimum Period of Isolation of Patient

No restrictions except for exclusion from organ and blood donation and counseling to modify activities in order to prevent
transmission.

Note: Sexual transmission of hepatitis C does occur, but is infrequent.

Minimum Period of Quarantine of Contacts

None     

B. Protection of Contacts of a Case

Personal surveillance for high-risk contacts is recommended. Personal surveillance is defined as the practice of close medical or other supervision of contacts without restricting their movements in order to promote recognition of infection or illness.

Standard Precautions for cases are recommended to prevent exposing others to blood and body fluids. Immune Globulin prophylaxis is not effective and is not recommended for those exposed to HCV-infected individuals, such as healthcare workers who receive a needle stick with a contaminated needle.

C. Managing Special Situations

There are no specific regulations regarding HCV infection in child care settings, food service environments, or in schools or community residential programs. HCV is not spread via casual contact or through food or water. As long as Standard Precautions are maintained, HCV will not be spread to others in these settings. No one who is HCV-infected should be excluded from attending or working in any of these settings on the basis of their HCV infection.

D. Preventive Measures

The role of the local health department in managing hepatitis C is largely educating infected persons how to care for themselves and avoid spreading infection to others. Little epidemiologic investigation is required except data collection for case reports. Prevention and education includes information on how the disease is transmitted, how to avoid transmitting it, and how patients can protect themselves from more liver damage. Offer the information and support below to people newly identified with hepatitis C.

  1. Provide basic instruction on transmission of HCV and emphasize the need for ongoing medical evaluation. Treatment is available and the patient should be referred to their healthcare provider for treatment options.
  2. If the patient is currently injecting drugs, provide referrals to syringe access and disposal programs (if available), substance use treatment programs, and general harm reduction information. This will help prevent the spread of hepatitis C to other individuals.
  3. Educate on the need to completely abstain from alcohol to help protect the liver. If a patient needs or wants support to stop drinking, provide referrals to appropriate treatment or support services.
  4. Discuss medications that should be avoided (e.g., acetaminophen) as high doses of certain medications can damage the liver. All patients should discuss any medications (including over-the-counter medications), dietary supplements, and herbs with a healthcare provider prior to taking them to be certain they will not damage their liver.
  5. Provide information on hepatitis A and B immunization. (Refer to the Hepatitis A and B chapters in this manual.)
  6. Discuss sexual transmission of HCV. Indicate that HCV may be transmitted during sex. All contact with blood during sex should be avoided. Emphasize latex barrier protection as a way to prevent the spread of HCV, as well as being a way to prevent the exposure to and transmission of other pathogens.
  7. Discuss household transmission of HCV. Household transmission is rare, but to ensure that it does not happen, the patient should not share razors, toothbrushes, nail clippers, or any other item that could be contaminated with blood with other household members.
  8. Inform the patient that they should not be restricted from working, preparing food, or taking part in their daily activities unless they have specific symptoms that make it difficult to do so. There are no recommendations suggesting that HCV-infected persons change their exercise routines or have any dietary restrictions.