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Hepatitis C is a chronic liver infection that can be either silent (with no noticeable symptoms) or debilitating. Either way, 80% of infected persons experience continuing liver destruction. Chronic hepatitis C infection is the leading cause of liver transplants in the United States. The virus that causes it is blood borne, and therefore patients who undergo frequent procedures involving transfer of blood are particularly susceptible to infection. Kidney dialysis patients belong to this group. In 2008, a for-profit hemodialysis facility in New York was shut down after nine of its patients were confirmed as having become infected with hepatitis C while undergoing hemodialysis treatments there between 2001 and 2008.

When the investigation was conducted in 2008, investigators found that 20 of the facility’s 162 patients had been documented with hepatitis C infection at the time they began their association with the clinic. All the current patients were then offered hepatitis C testing, to determine how many had acquired hepatitis C during the time they were receiving treatment at the clinic. They were considered positive if enzyme-linked immunosorbent assay (ELISA) tests showed the presence of antibodies to the hepatitis C virus.

Health officials did not test the workers at the hemodialysis facility for hepatitis C because they did not view them as likely sources of the nine new infections. Why not?

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Why do you think patients were tested for antibody to the virus instead of for the presence of the virus itself?

Ref.: Cowan, M. K. (2014) (4th Ed.). Microbiology: A Systems Approach, McGraw Hill



Directions for the students: There are 4 essay questions. Please be sure to complete all of them with thorough substantive responses. Current APA Citations are required for all responses. 

1. Precisely what is microbial death?

2. Why does a population of microbes not die instantaneously when exposed to an antimicrobial agent?

3. Explain what is wrong with this statement: “Prior to vaccination, the patient’s skin was sterilized with alcohol.” What would be a more correct wording?

4. Conduct additional research on the use of triclosan and other chemical agents in antimicrobial products today. Develop an opinion on whether this process should continue, providing evidence and citations to support your stance.