Hepatitis B outbreaks in home healthcare.

T he monitoring of a patient’s blood glucose level is an important component of routine diabetes care. In home care and hospice patients, capillary blood is typically sampled using a fingerstick device and tested with a portable blood glucose meter. During this procedure, the Hepatitis B virus (HBV) can be easily transmitted if infection prevention and control procedures are not meticulously adhered to. The first reported outbreak of HBV associated with the use of a fingerstick device in the United States was in 1990 (Centers for Disease Control and Prevention [CDC], 1990). Since that time, long-term care facilities have been found to be a common setting for the transmission of HBV. To prevent outbreaks of HBV infections associated with blood glucose monitoring, the CDC and the Food and Drug Administration (FDA) have recommended that fingerstick devices be restricted to individual use (CDC, 2011; FDA, 2010). Even as such, 87% of the HBV outbreaks reported in the United States between 2008 and 2013 were associated with infection control breaches during assisted monitoring of