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Hepatitis C in the Workplace: Should Health Care Professionals Disclose?

healthcare and hepatitis C

Should health care professionals disclose HCV status?

About nine months ago, a hepatitis C advocate contacted me and asked if I would be open to having a discussion on hepatitis C among healthcare professionals. Specifically, should we disclose or shouldn’t we? He talked about hepatitis C-positive medical professionals faced with the dilemma of disclosing their hepatitis C status to their employer. Some who divulged their status were terminated. There are also cases of those who were denied a job because pre-employment screening revealed that they had hepatitis C.

He wrote, “What aggravates me the most about it is that most of these dedicated medical professionals where infected doing their job. Many were infected when precautionary measures were not as stringent as they are today. They understood the risks when undertaking and committing to the profession, and simply took it as part of being in the line of duty…to prevent them from continuing to pursue their career due to their viral infection is just WRONG!”

I said I would write the article, and then I didn’t. I procrastinated because it is a tough subject. The public is afraid. My experience with some patients is that they don’t trust health care professionals. Look at what we did to the health care workers who returned after doing a stint with Ebola – the toughest medical job there is. The press dogged them; we tried to ostracize them.  Kaci Hickox, the nurse who defied the ridiculous New Jersey quarantine, was called the “Ebola nurse.” She never had Ebola.

As a nurse, I have been publicly attacked for “exposing patients to hepatitis C.” For the record, patients were never at risk of acquiring hepatitis C from me. However, I don’t need to defend myself. The evidence speaks for itself. The U.S. Centers for Disease Control and Prevention (CDC) does not recommend restrictions for HCV-infected health care workers. The CDC recommends that we follow good infection control practices. It isn’t legal to terminate health care workers with hepatitis C who perform their jobs safely. However, we all know that terminations are conducted in a variety of ways, and the reasons can be covered up.

So, why did it take me so long to write this? There is another side—the dirty side of medicine that we in health care don’t want to acknowledge—medical harm. Sometimes our medical system fails us. If you spend any time reading news on the Internet, you probably heard about the oral surgeon in Tulsa, OK who may have exposed as many as 5,000 patients to HIV, hepatitis B and hepatitis C. Or, perhaps you read about the travelling health care technician, David Kwiatkowski, who left a trail of hepatitis C infections behind him. Kwiatkowski was a hepatitis C-positive injection drug user who helped himself to potent pain and anesthesia drugs meant for patients. He refilled the syringes with sterile saline. Not only did he expose patients to hepatitis C, he also put them at risk of insufficient pain relief or anesthesia.

I read these stories and I understand why patients are afraid. The world is a scary place, and the one place we want a guarantee of safety is in health care. I have been on both sides of this debate, as both nurse and as patient. As a patient, I was the victim of a lab technician who reused needles. I already had hepatitis C. I was more concerned about anyone who had their blood drawn after me than I was by what I could have contracted from those who were before me.

I won’t let a few bad apples spoil the entire barrel. Nearly every medical professional I know is amazing. When I think of the work that Kaci Hickox and other Ebola Warriors did, I am humbled.

So, should we disclose our hepatitis C status? I don’t know. I already have, so for me it is a moot point. On one hand, speaking up is how we confront stigma. Disclosure is a radical act. On the other hand, the risk is huge, and it cannot be undone. It is sad to watch good people drummed out of their jobs. I think it is a personal decision. What do you think?

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  • Connie Welch January 15, 2015, 5:51 PM

    Hi Lucinda,
    I know this is a hard call to disclose info. On a personal note, I was infected with Hep C through the very same way the above mentioned David K. did, and it’s amazing, his name was also David but he had a different last name. But in cases where abuse or neglect practices are made, I am a strong advocate that patients have a right to know. But for other cases of health care professionals who are doing their job and practicing safety procedures, they should not be made to feel the sting of stigma or lose their jobs. I always watch to make sure someone is using gloves when they need to and handling syringes safely, if not, I’ve been known to speak up. I think majority of health professionals do an outstanding job. Thanks for writing the article.

  • Fly Girl January 15, 2015, 7:40 PM

    I know this is going to upset many, and I can admit my answer might very well be different if I didn’t have HEP C, but I do. And knowing what I’ve gone through trying to get rid myself of this virus, and am still going through and knowing my liver is damaged to the point of F4 and I wasn’t aware until just a couple of months ago. . I’m sorry but health care workers have a responsibility to disclose their HEP C status unless they are SVR. How can you be a health care worker, and knowing how serious HEP C is, and not allow your patients to decide for their selves if they should seek another provider??

    • Kelly March 19, 2017, 11:02 AM

      Isn’t it true that you can’t get a cosmotology license if you are positive for Hep C? What other job can you not get approved for if you have it?

      • Lucinda Porter March 20, 2017, 10:31 AM

        There are no job restrictions if you have hep C, but some employers will not hire people with hep C.

  • Barb August 24, 2017, 5:28 PM

    I’ve been a nurse for 22 yrs. and today was a first for me. I have done travel nursing in and off since 2012. But I have never come up against this…
    I was asked to take a Hepatitis C titer!
    My first reaction was “how intrusive “!
    My second was “next they’ll be asking my my HIV status, whom do I sleep with and are you a friend or foe of the government”! Maybe this is over-reactive- and maybe I’ve been exposed to much Big Brother issues – but how can and why is that relevant?!
    As a healthcare worker my biggest risk is from my patients! But we do not invade their privacy like that-it’s a law!!!
    What do you do that to me?
    An RN who doesn’t want to know or be labeled…

    • Lucinda Porter August 27, 2017, 3:23 PM

      This is very disturbing. Please let me know how this progresses.

  • Unknown May 17, 2018, 4:17 PM

    I recently accepted a job at daycare, and the paperwork they gave me after I accepted the job requires a physician to disclose whether or not I have a communicable disease or a disease that is contagious is this right for the doctor to disclose

    • Lucinda Porter May 21, 2018, 11:06 AM

      Hepatitis C is not communicable in work normally done at a day care center. If they don’t test you for it, your doctor will have nothing to disclose.

      • Concerned September 9, 2019, 7:56 PM

        I am a MA about to start RN school and they gave me paperwork to have my doctor fill out as well asking if I have “any communicable diseases that would prevent or hinder my ability to become a member of the healthcare profession” I am SVR and have no viral load when tested, will my doctor list this on my paperwork and can they deny me entry into school? I have been trying to finish my medical schooling for many years, this is really worrying me!

        • Lucinda Porter September 11, 2019, 5:08 PM

          This should not prevent you from reaching your dreams.

  • Faye December 16, 2018, 9:14 PM

    So we all know that if your injured as a nurse and disclose it when you apply be it admitteing to the MRI or injury workers comp or whatever you can kiss that job goodbye. If you do not think this is true try it. They do not care. It’s business and the bottom line is nurses are just a number. There’s always one to replace you. I was angry to say the least that I have acquired both during a 29 year ministry as a nurse. It was never just a job to me but a calling. The cold hard truth is you don’t see very many nurses working in patient care in their 50,60 or 70’s. Why exactly is that? Ask a few older nurses who have been job hunting without injuries or illnesses. I should have planned better 29 years ago but never ever thought I wouldn’t quite bounce back after my second back injury and now this. Will I divulge the information. Considering I’m a single parent to a disabled 34 year old can no longer physically work a full time job and still fighting with disability after I was approved but made to reapply because I made 25,000 the year after the back injury even tho I never worked over 10 hrs a week was being sexually harassed by the CEO and paid 175$ a week to take call continued to pay 210$ a month for a pain management doctor, living in section 8 housing and trying to survive on my sons disability with no help from anyone. I can’t afford to tell anyone…I am not doing patient care and the thought of it sends my heart rate thru the roof now. It’s a no win situation. I did try telling the truth about the back injury the first time, they made me take a lift test that was impossible. I basically cried and begged my way past that one. Now I’m just trying to survive have worked as a cashier for 10$ an hour loved it but couldn’t do it either due to my back and now hep c. Starting the medication this week. Praise God it is being paid for this month albeit DHS trying to bill me 400$ for the insurance and I have no income. Appealing the disability and it will go to a judge next 2 1/2 years after the on the job injury, btw don’t waste 400$ a month buying all the long term short term insurance..,.not worth the paper it’s written on, another lesson learned the hard way. Wish I had put that money into a 401k or whatever, anything else would have been better than flushing it down the toilet.