Patient advocates are raising concerns about a gap in California's public reporting of cases of Clostridium difficile, which has become one of the most deadly types of infections in the U.S., the Stockton Record reports.
About C. Difficile
C. Difficile is a serious gastrointestinal infection that spreads by tiny spores and is common in health care settings. Symptoms can include severe diarrhea and abdominal pain.
According to federal estimates, 14,000 to 30,000 individuals nationwide die of the condition annually.
Details of State Reporting Requirements
California requires only hospitals to report cases of C. difficile. Those reports are sent to the California Department of Public Health, which in 2010 began issuing annual public reports about hospital infections.
However, other health care facilities -- such as physician offices, nursing facilities and surgical centers -- are not required to report C. difficile cases.
According to CDC, only 25% of individuals who have C. difficile show symptoms of the condition while at a hospital. The remaining 75% of cases are identified in other settings, such as nursing homes and physician offices.
Advocates, Experts Express Concern
Experts and patient advocates argue that C. difficile reporting in California should include other health care facilities.
State law calls for health care providers to report "outbreaks of any disease" to local health officials, but advocates say the measure is too vague.
Carole Moss -- who helped push for the state's 2008 hospital reporting law after her son died of a different hospital-acquired infection -- said DPH has the authority to make C. difficile a reportable disease.
A spokesperson from the public health department in an email wrote that the agency "consults with the California Conference of Local Health Officers on a regular basis to add diseases of public health significance to the reportable list."
However, DPH's Office of Public Affairs declined the Record's request for direct interviews with health department officials about reporting of C. difficile (Goldeen, Stockton Record, 10/15).
Two Hospitals See High C. Difficile Rates
Meanwhile, Dameron Hospital and Lodi Memorial Hospital in San Joaquin County rank among the worst in the state for rates of C. difficile.
However, the high rates of C. difficile at those hospitals could be the result of the facilities using a more modern, sensitive diagnostic test than other hospitals, according to the Record.
A two-month Record investigation identified several flaws associated with state and federal tools used to diagnose and track C. difficile. It also found that many cases go uncounted.
The Record articles were produced by the California HealthCare Foundation's Center for Health Reporting. The center is supported by a grant from CHCF, which publishes California Healthline (Goldeen, Stockton Record, 10/14).