Dental warning over HIV and Hepatitis infection risk to children from contaminated equipment sparks inquiry

Counties Manukau DHB said there was a very small chance children who had particular procedures have been exposed to unsterilised water. Photo / 123rf
Counties Manukau DHB said there was a very small chance children who had particular procedures have been exposed to unsterilised water. Photo / 123rf

Children treated at an Auckland dental clinic may be at risk of Hepatitis and HIV after a contamination scare.

About 2500 children who visited Pukekohe Intermediate Dental Clinic between September 13, 2016 and January 23 could be at risk due to malfunctioning dental equipment.

Counties Manukau DHB said there was a "very small chance" children who had particular procedures have been exposed to unsterilised water, possibly containing blood or saliva from other children.

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An investigation is under way into the exact nature of the problem and how it occurred.

Specialist public health nurses will contact parents and caregivers of children who might have been affected to arrange appropriate screening.

Children who have had a procedure involving compressed air, a drill, extraction or suction, will be offered testing for blood-borne viral infections, in particular Hepatitis B, Hepatitis C and HIV.

However, infectious disease specialists have indicated the risk of cross-infection is very low as it is extremely rare for New Zealand children to have any of these conditions.

"If we do find cases of pre-existing infection, then we will prioritise screening for those children who were treated on the same day," Counties Manukau chief medical officer Dr Gloria Johnson said.

"Some children may also need catch-up immunisations against Hepatitis B."

There is extremely low risk of infection, if any, to other family members.

Engineers are investigating how the problem could have occurred including involving a specialist maintenance company and the United States manufacturers of the equipment.

"The problem occurred due to equipment assembly and is not related to the clinical practice of the dental staff at the clinic, or the high-quality care given to children across Auckland," Dr Johnson said.

Dr Johnson said incidents of this nature are extremely rare and parents should not let this affect their children's attendance at school dental clinics.

"Our investigation will determine what longer-term mitigations need to be put in place to ensure this type of fault doesn't occur in future."

As a result of this incident, all Auckland Regional Dental Service dental clinics in the Auckland Region have been reviewed and the issue is only with the Pukekohe Intermediate Dental Clinic.

Anyone with concerns is encouraged to contact Healthline on 0800 611 116 or talk to their GP if they require further information or support.


COUNTIES MANUKAU HEALTH Q+A FOR WHANAU AND GUARDIANS


What is the health risk?

Malfunctioning equipment at the Pukekohe Intermediate Dental Clinic means there is an extremely low chance that children who received treatment between 13 September 2016 and 23 January 2017 may have been exposed to unsterilised water, potentially containing saliva and blood from other patients at the clinic.

There is a very small risk of exposure to a blood-borne infection as a result of this equipment malfunction.

The likely risk of children being exposed to a blood-borne virus is very low. Hepatitis B virus, Hepatitis C virus, and HIV infection are all extremely rare in New Zealand children.

Most children with up-to-date immunisations are also fully protected against Hepatitis B.

If at any stage we do find cases of pre-existing infection, then we will prioritise screening for those children who were treated on the same day.

Children who have not been fully immunised for Hepatitis B should have catch-up Hepatitis B vaccinations.

Blood tests will also be offered to screen for Hepatitis B virus, Hepatitis C virus, and HIV infection.


What test would my child need to have?

We are offering a blood test for Hepatitis B, Hepatitis C, and HIV infection.

This test can be done at the clinics that have been established or a community laboratory upon referral by your GP.

Because infection with blood-borne viruses may take a number of weeks to develop, a second blood test may be needed up to three months from the time of the exposure.


What will happen if my child returns a positive test?

In the very low likelihood that your child has a positive test, the specialist clinic team will work with you to recommend an appropriate plan.


How long before I know that my child is not infected once they are tested?

The blood test results usually come back within 48 hours. Due to the slow incubation of blood-borne viruses, a second blood test may be needed up to three months from the time when your child had their dental treatment.


What if my child has contracted another illness?

No special testing is required for other infections if your child is otherwise healthy.

However, at your clinic appointment, we will consider any other concerns you have about your child's health.

If you have any remaining concerns, please visit the clinics that have been established, contact Healthline on 0800 611 116, or seek advice from your GP.


Did this issue impact the mobile dental truck based at Pukekohe Intermediate Dental Clinic?

No. The mobile clinic was not affected. As a precaution, all other Auckland Regional Dental Service (ARDS) dental clinics and trucks in the Auckland Region were immediately inspected.

The issue is only with the Pukekohe Intermediate Clinic, and only has the potential to impact children who received treatment from 13 September 2016 until 23 January 2017.


Is there any risk to other family members?

There is extremely low risk of infection, if any, to other family members. However, if you have any concerns please visit the clinics that have been established, contact Healthline on 0800 611 116, or seek advice from your GP.


What should I do?

If your child was seen at the Pukekohe Intermediate Dental Clinic between 13 September 2016 and 23 January 2017, we will make contact with you by phone. We will also be writing to all families and caregivers who had children visit the clinic during the period in question.

If you have any remaining concerns, please contact Healthline on 0800 611 116, or seek advice from your GP. More information is available on our dedicated website: http://www.countiesmanukau.health/ardspukekohe.nz

If your child has an immediate health concern, please contact your GP, the Accident and Medical Clinic, or dial 111 in an emergency.


Where are the Specialist Clinics based?

Two clinics will be established from 9am on 1 February. One will be based at the Pukekohe Intermediate Dental Clinic at 2a Edinburg St, Pukekohe and the other at Pukekohe Hospital.

These clinics will initially operate from 8am until 8pm seven days per week and be staffed by Public Health Nurses.


What makes you certain this isn't happening at other dental clinics?

As a precaution, all other ARDS dental clinics in the Auckland Region were immediately checked. The issue is only with the Pukekohe Intermediate Clinic, and only for the period from 13 September 2016 until 23 January 2017.

We are not concerned about other children receiving dental treatment in the Auckland Region.

Our investigation will determine what longer-term changes may need to be put in place to prevent this malfunction from arising again.


What is Hepatitis B?

Hepatitis B is caused by a virus which can cause inflammation of the liver. It was a common disease in New Zealand until a vaccine was introduced in the 1980s. Most children who have received their full course of infant immunisations are immune to Hepatitis B.


What is Hepatitis C?

Hepatitis C is a blood-borne virus which causes inflammation of the liver. The incidence amongst children is very low.


What is HIV infection?

HIV, or the Human Immunodeficiency Virus, damages the immune system and can be transmitted by sexual contact, exposure to blood or from a mother to her child around the time of birth. In New Zealand, HIV is extremely uncommon in children.

- NZ Herald

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