Four patients suffered from acute hepatitis C and visited our hospital sequentially during August to October 2008. We immediately set up an investigating committee including members of outside our hospital. The four patients all had been hospitalized during April to May 2008, and the hepatitis C virus El sequence of the three patients matched each other with 98-99% identity. Therefore, we concluded this infection as a nosocomial infection. However, in spite of the intensive investigation, the route of transmission has not been clarified. In two of the four patients, hepatitis C healed spontaneously and HCV-RNA became negative, one patient was cured by interferon therapy, and one patient became chronic hepatitis. As an action for prevention of nosocomial infection, we trained all the medical staffs on the standard precaution, reassessed the medical work and procedures and the surroundings around the ward, and no patients of acute hepatitis C of nosocomial infection have been seen thereafter. In conclusion, to prevent nosocomial hepatitis C virus infection, the act plan over the hospital containing the surveillance is needed.
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