Clinical labs, dental clinics main sources of infection There has been a considerable increase in the number of hepatitis-B cases reported in the district, according to a study. A report on the six-month study conducted by Rakesh P.S., an epidemiologist attached to the Integrated Disease Surveillance Project (IDSP) in Kollam, has been submitted to the District Medical Officer here. Risk factor “A blood test or a visit to a dentist was identified as a major risk factor for hepatitis-B infection in the district.” The report calls for stringent action against all clinical laboratories found to be violating safety norms and employing staff who lacked proper technical qualifications. As part of the emergency steps to be taken for the immediate prevention of the infection, District Collector P.G. Thomas on Saturday issued orders under Section 144 of the Code of Criminal Procedure (CrPC) directing all clinical laboratories in the district to ensure that they operated strictly as per norms. As per the order issued in his capacity as the District Magistrate, clinical laboratories were directed to operate only under licence from respective local bodies and with qualified technicians. Careful disposal The laboratories should ensure careful disposal of biological wastes and sharps; should have all necessary infrastructure and autoclave facilities; and should carry out adequate sterilisation of instruments. Corrective measures The laboratories have been directed to take these corrective measures within 15 days from August 18, 2012. “If any flaws were found after the prescribed time, such laboratories will be penalised for endangering public health.” The study report by Dr. Rakesh says that the total number of hepatitis-B cases reported in the district till June 30 is 264. “This is almost double as compared to the 224 cases in the district during the whole of 2011. This year five deaths due to hepatitis-B have been reported in the district.” The report says that a majority of the private laboratories in the district are working without licences and a good number of the laboratories were not disposing of the sharps properly. Needles are not removed and shredded, and are often found discarded carelessly on the premises with syringes intact. In many laboratories, the steriliser was not in the working condition. The report calls for awareness campaigns and official-level action to raise public awareness of the safety concerns connected to clinical laboratories. Transmission of hepatitis-B virus (HBV) occurs in all age groups, through percutaneous and permucosal exposure to infectious body fluids from persons with acute or chronic HBV infection. The highest concentration of the virus occurs in blood and serum fluids and most frequently infection occurs through direct inoculation of the virus. The report says that in majority of the laboratories, the technicians were not using gloves while handling sharps and at half the number of dental clinics sterilisation of instruments was not done properly. The majority of the lab workers were also not vaccinated against Hepatitis-B. 264 hepatitis cases reported so far this year Many clinics do not sterilise equipment properly