Pubdate: Thu, 17 Oct 2002
Source: New York Times (NY)
Copyright: 2002 The New York Times Company
Contact:  http://www.nytimes.com/
Details: http://www.mapinc.org/media/298
Author: Barry Meier
Bookmark: http://www.mapinc.org/findUKP143 (Hepatitis)

HEPATITIS CASES MAY BE LINKED TO NEEDLES AT CLINIC

At least 10 cancer patients treated at a Nebraska clinic have contracted 
hepatitis C, possibly because of hypodermic needle reuse there, and the 
number of those infected could rise, a state health official said yesterday.

Dr. Thomas Safranek, the state epidemiologist for the Nebraska Health and 
Human Services System, said health officials believed that another 10 
people might have become infected with the virus at the clinic.

The authorities have sent out letters to about 600 people seen over 22 
months at the clinic in Fremont, Neb., urging them to seek testing.

"It is the biggest single episode of a health care-related infectious 
disease outbreak in Nebraska," Dr. Safranek said.

He said health officials had yet to determine a cause for the outbreak. But 
he said they were looking at the possibilities that someone at the clinic 
might have used the same contaminated needle and syringe to treat multiple 
patients or that needle reuse had caused a vial of medication to become 
contaminated by the hepatitis C virus.

"Our concern is that a syringe or needle that was previously contaminated 
was used to access a solution," Dr. Safranek said.

If so, it would be the second major outbreak of hepatitis C involving 
needle reuse at a health care site nationwide in recent weeks.

Officials at Norman Regional Hospital in Norman, Okla., recently said at 
least 52 people who had been treated at a pain clinic there were infected 
with hepatitis C after a nurse used the same needle and syringe to give 
drugs to many patients.

More than four million people in the United States are infected with 
hepatitis C, and experts say the virus is frequently transmitted when an 
infected drug addict shares a hypodermic needle with an uninfected person. 
Hepatitis C is the most virulent form of the hepatitis virus and can lead 
in a small percentage of cases to serious liver damage and liver cancer. 
While some people can naturally overcome the virus, an estimated 50 percent 
to 70 percent of those infected with it remain chronically infected. The 
disease is treated with a combination of interferon and the drug ribavirin.

The Nebraska clinic, which specialized in chemotherapy and hematology, shut 
down on Tuesday. It was at Fremont Area Medical Center, near Omaha. Dr. 
Safranek, the state official, said it was his understanding that the clinic 
was run independently by a local physician, Dr. Tahir Javed.

Dr. Safranek said the episode came to light when a local doctor noticed 
that several patients had a rare strain of hepatitis C, genotype 3A. All 
turned out had been treated at the Fremont clinic.

Those contacted for testing were seen at the clinic from March 1, 2000, to 
Dec. 31, 2001.

A spokeswoman for the hospital said Dr. Javed left for Pakistan several 
months ago citing a family emergency and had not returned.
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