A woman who underwent uterine surgery in New Jersey hospital acquired hepatitis C through an anesthesiologist’s medicine cart, the Journal of the American Medical Association reported this month. Unlike the syringes and vials used in surgery, the carts were not sterilized. Right before the woman’s operation, another patient, who had already been diagnosed with hep C, was anesthetized by the same person, using the same cart. Five weeks later the second patient was diagnosed. Both patients were found to have the same genotype.

The anesthesiologist gave propofol, a short-acting hypnotic, to both patients. It may have come into contact with the cart’s contaminated surface, investigators from the New Jersey Department of Health concluded.

The infection, which occurred in 2010,  sparked a Centres for Disease Control and Prevention warning that health-care personnel should be continually trained in  infection control. In the United States and Canada, transmission through medical practices is rare, but in the developing world, it’s still a big problem. The World Heath Organization is working on ways to solve it.