Hep B Transmitted by Shared Glucometers in Care Facility

Hepatitis B virus (HBV) was transmitted to a person in a long-term care facility via shared blood glucose monitors, the US Centers for Disease Control and Prevention (CDC) reported. 

“Sharing glucometers presents a risk for HBV transmission that can be reduced by routine HBV vaccination of persons with diabetes and dedicating individual glucometers to a single resident,” the CDC said in the August 7 issue of the Morbidity and Mortality Weekly Report. 

During 2008-2019, the CDC reported 15 outbreaks of HBV and hepatitis C virus in US long-term care facilities due to the same practice. 

In the recent case, the patient was 69 years old with diabetes and no history of HBV or HBV vaccination when diagnosed with acute HBV in May 2024. Investigation revealed that the patient lived in a skilled nursing facility room close to another resident with diabetes who had a previously unreported chronic HBV infection. 

During March-April 2024, both received glucose monitoring from one of two devices stored on a single medical cart, and the recorded timing between tests suggested that disinfecting practices had not been followed. 

However, the CDC pointed out that even when disinfection protocols are followed, HBV transmission can still occur with sharing of equipment that is in contact with blood. For that reason, the agency recommends assigning each resident a dedicated glucometer and administering HBV vaccination to all people aged 60 years and older with diabetes. 

“The findings of this investigation highlight [assisted monitoring of blood glucose] as a risk factor for HBV transmission and provide evidence that skilled nursing facilities might be an appropriate setting to offer hepatitis B vaccination,” the CDC concluded.

Miriam E. Tucker is a freelance journalist based in the Washington DC area. She is a regular contributor to Medscape Medical News, with other work appearing in the Washington Post, NPR’s Shots blog, and Diatribe. She is on X @MiriamETucker and BlueSky @miriametucker.bsky.social.