Hepatitis C Virus Transmission Associated With Drug Diversion in a Local Hospital Emergency Department — Washington State, August 2017–March 2018

  • We identified 13 patients with genetically similar hepatitis C virus infections; 12 of them likely acquired the infection from a nurse who admitted to having diverted patients’ injectable opioid pain medicine for personal use.
  • Healthcare providers are not immune to the current opioid epidemic. Some who are struggling with addiction may use their position to access controlled substances such as opioids for their personal use, and in the process, tamper with the medicine and put their patients at risk of infection or substandard care.
  • Healthcare facilities should actively monitor how controlled substances are used, and should conduct investigations whenever they suspect diversion activities may be occurring. Drug diversion should be reported to authorities, and patients who may have been affected by diversion activities should be identified and linked to care if needed. Some of the patients identified as part of this outbreak did not know that they had hepatitis C virus infection, which is treatable. Untreated patients are at not only at risk of developing chronic liver disease, which may lead to liver cancer, but may also transmit the infection to others.
Quote from the Disease Detective

“We were able to identify the nurse who diverted patients’ drugs by reviewing the automated drug dispensing system’s logs, which showed that the nurse had accessed the system more frequently than other staff members in the hospital’s emergency department. This outbreak highlights the need for healthcare facilities to secure and actively monitor use of controlled substances at their facilities in order to protect their patients from harm caused by drug diversion.”

– Henry Njuguna, MBChB, MPH, EIS Class of 2017

EIS officer Henry Njuguna[JPG - 1 MB]

EIS officer Henry Njuguna, MBChB, MPH, prepares a report on the hepatitis C virus investigation in his office at the Washington State Department of Health

Contact Information

CDC Media Relations
(404) 639-3286

Conference Information
Henry Njuguna


Henry Njuguna, MBChB, MPH,
EIS Class of 2017
Washington State Department of Health

Education: MBChB: University of Nairobi, 2004
MPH: Jomo Kenyatta University, 2011
Strathmore College, School of Accountancy, 1999

Work Experience: Public Health Specialist/Medical Epidemiologist, Centers for Disease Control and Prevention Kenya, 2010-Present
Quality Improvement Officer, International Center for AIDS Care and Treatment Programs (ICAP) Kenya, 2010-2010
Chief Medical Officer/Research Assistant, Kenya Medical Research Institute and Centers for Disease Control and Prevention Kenya, 2006-2010
Intern: Kenyatta National Hospital, 2005-2006

Volunteer Experience: Board Chairman, Rafiki AIDS Ministry, 2008-Present
Clinic Patron, Dr. Terry and Barbara Upendo Clinic, 2011-Present
Secretary General, Association of Medical Students University of Nairobi, 2003-2004