October 17, 2002
Hepatitis Cases May Be Linked to Needles at Clinic
By BARRY MEIER
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.