Hepatitis C Virus (HCV)

Characteristics

Morphology Enveloped +ssRNA virus that is 50 nm in diameter, Flavivirus family, Hepacivirus genus
Growth Conditions Cell culture

Health Hazards

Host Range Humans, experimentally transmitted to chimpanzees
Modes of Transmission

Contact with infected blood through sharing needles, needle-stick injuries, sexual contact, and birth to an infected mother

Signs and Symptoms

75-80% of newly infected people develop chronic infection whereas 20-30% develops acute infection.

  • Acute Infection: Fever, anorexia, nausea, vomiting, jaundice, no lasting liver damage
  • Chronic Infection: Chronic liver disease, cirrhosis of the liver, liver cancer, death
Infectious Dose Unknown.
Incubation Period 14 – 180 days (45 day average)

Medical Precautions/Treatment

Prophylaxis None available
Vaccines None available
Treatment
  • Acute Infection: Antiviral and supportive treatment
  • Chronic Infection: Monitoring for liver disease progression; antiviral therapy
Surveillance
  • Acute Infection: No serological marker available, PCR test for HCV nucleic acid
  • Chronic Infection: Screening assay for HCV antibody (anti-HCV), PCR for HCV nucleic acid
Emory Requirements Report all exposures to human blood, OPIM or HCV infected material

Laboratory Hazards

Laboratory Acquired Infections (LAIs) Prevalence of anti-HCV is slightly higher in health care workers than the general population. Parenteral inoculation is the predominant cause of HCV in health care workers.
Sources Human blood, other potentially infected material (OPIM), inadequately sterilized instruments, needles, syringes

Supplemental References

Canadian MSDS http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/index-eng.php 
BMBL: 5th Edition http://www.cdc.gov/OD/ohs/biosfty/bmbl5/BMBL_5th_Edition.pdf 
CDC Guidelines https://www.cdc.gov/hepatitis/HCV/index.htm 
OSHA Bloodborne Pathogen Standard (29 CFR 1910.1030): https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=standards&p_id=10051 
Virology Journal Song et al: Thermal stability and inactivation of hepatitis C virus grown in cell culture. Virology Journal 2010, 7:40. http://www.virologyj.com/content/7/1/40 

Containment

BSL-2 Work with known or potentially infectious material
BSL-3 Procedures involving production quantities of infectious material (over 10L of culture) and activities with high potential for aerosol production
ABSL-2 Work with infected non-human primates

Spill Procedures

Small Notify others working in the lab. Allow aerosols to settle. Don appropriate PPE. Cover area of the spill with paper towels and apply an appropriate disinfectant, working from the perimeter towards the center. Allow appropriate amount of contact time before disposal and cleanup of spill materials.
Large

Contact Emory’s Biosafety Officer (404-727-8863),
the EHSO Office (404-727-5922), or
The Spill Response Team (404-727-2888).

Exposure Procedures

Mucous membrane Flush eyes, mouth or nose for 15 minutes at eyewash station.
Other Exposures Wash area with soap and water for 15 minutes.
Reporting Immediately report incident to supervisor, complete an employee incident report in PeopleSoft.
Medical Followup 

7am-4pm (OIM): EUH (404-686-7941) EUHM (404-686-7106) WW (404-728-6431)

After Hours: OIM NP On Call 404-686-5500 PIC# 50464

Needle Stick (OIM): EUH (404-686-8587) EUHM (404-686-2352)

Yerkes: Maureen Thompson Office (404-727-8012) Cell (404-275-0963)

Viability

Disinfection Cell culture-derived HCV (HCVcc) susceptible to 4% formaldehyde, 2.5% glutaraldehyde, and detergents (ionic and non-ionic).
Inactivation HCVcc inactivated when incubated at 60°C for 8 minutes and 65°C for 4 minutes
Survival Outside Host HCVcc remains stable at 37°C for 2 days and at room temperature for 16 days

Personal Protective Equipment (PPE)

Minimum PPE Requirements At minimum, personnel are required to don gloves, closed toed shoes, lab coat, and appropriate face and eye protection prior to working with HCV. Additional PPE may be required depending on lab specific SOPs.
Additional Precautions

Take precautions when handling sharps. Use respiratory protection if work will be performed outside the biosafety cabinet. Additional precautions should be considered with work involving animals or large scale activities.

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