The Southern Nevada Health District plans to begin telephoning people who've tested positive for hepatitis C to try to determine the source of their infection. It could be months and possibly years before the health district can figure out just how many people are affected.
The effort represents the next phase of a regional investigation of unsafe injection practices at the Endoscopy Center of Southern Nevada. Some 40,000 people are being notified by letter to get tested for the potentially deadly virus, along with another strain of hepatitis and HIV, the virus that causes AIDS.
Cases of hepatitis have jumped by more than 400-percent in just the last few weeks. They report seeing more than 150 people a day testing positive compared to the usual 20 to 40 people a day who test positive.
"Now we're getting this tidal wave of data coming in," said Brian Labus with Southern Nevada Health District.
Labus says September 21, 2007 was one of the days where hundreds of patients may have been infected with hepatitis at the Endoscopy Center. Through genetic testing, they have proven at least five cases were directly linked to that date.
People who had a procedure at the Endoscopy Center on the 21st were 28 million times more likely to be infected. The district is not certain that those cases are all linked to the medical clinics that were found to be reusing syringes and sharing vials of anesthesia among patients.
"Just because they are on the list and they're infected doesn't mean they were infected by the clinic," said Labus.
According to the health district, 1,600 patients of the endoscopy centers would have already had hepatitis C before being treated at the centers. Now, the health district must determine if those patients may have been the source of the spread of the disease.
"If we get several hundred reports a day, it could really be from any possible source," said Labus.
Investigators have been hampered because the clinic failed to keep proper records. Some colonoscopies appear to only have lasted for two minutes and calendars make it seem like one doctor is performing two operations at the same time.
"The times were questionable. It was really hard, based on their records, to put together really the sequence of events on days when we had the known transmission," said Labus.
It is just another challenge left over from the dangerous day now causing so many problems. So far investigators have handed over 35 names of doctors and nurses they feel are responsible for problems. They expect to face discipline from medical boards from across the state.
Patients will be interviewed by health officials about other possible sources of the disease including drug use, organ transplants, blood transfusions and their sexual partners. Testing is expected to continue through July as some patients who have the disease may not show positive yet.
The health district says it will need 200 volunteers to do the phone calls and interviews over the next several months.
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