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Mar. 01, 2008
Copyright © Las Vegas Review-Journal

CDC tries to allay fears

Consider 'risk seriously but not hysterically,' official says

By ANNETTE WELLS
REVIEW-JOURNAL
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Las Vegans who have spent the past 48 hours worrying about the possibility they've contracted hepatitis strains B or C or HIV, the virus that causes AIDS, received some small reassurances Friday from federal and state health officials.

"People need to be concerned but not overly afraid,'' said Dr. Scott Holmberg with the Centers for Disease Control and Prevention's Division of Viral Hepatitis. "The risk for any one person is very low.''

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    • Holmberg said there are two things people should keep in mind when considering their risk of contracting one of the blood-borne viruses that people might have been exposed to as a result of medical practices at the Endoscopy Center of Southern Nevada, 700 Shadow Lane.

    First, your risk increases if a patient who is infected was treated before you on the same day. In addition, not all nurse anesthetists at the facility were reusing their syringes, nor were all the reused syringes contaminating the vials.

    "So one's risk," Holmberg said, "is proportional to a low probability times another low probability.

    "People need to take the low risk seriously but not hysterically.''

    The Southern Nevada Health District has sent letters to 40,000 patients who underwent procedures at the Endoscopy Center between March 2004 and Jan. 11, urging people to get tested for the hepatitis strains or HIV.

    Holmberg noted that although there may be patients who end up testing positive for hepatitis C, it's no certainty they contracted it from the clinic.

    Health district officials believe five people were infected with hepatitis C at the Shadow Lane center on Sept. 21 after nurse anesthetists reused syringes to administer medication.

    One contracted the disease on July 25. Nurse anesthetists are certified registered nurses who administer anesthesia.

    The five cases "pretty clearly are related, but for others, unless we see a clear clustering of time, it will be hard to impute transmission in the clinic setting,'' Holmberg said. "We've already linked four of the five through genetic analysis. That means the viruses they have are the same, so we are near certain they got it from there.

    "We don't have the sample yet from the fifth person, but we are certain the transmission occurred there.''

    If a few more people are diagnosed with hepatitis C in the near future and they had procedures done on July 25 or Sept. 21, Holmberg said, the odds will be overwhelming that their cases are related, regardless of whether health officials have completed their genetic analysis.

    "Unless they were the first person to be seen,'' he said. "Then that person would be the index.''

    Hepatitis C is a blood-borne disease that infects the liver. The infection can cause liver inflammation that is often asymptomatic.

    It is spread by blood-to-blood contact with an infected person's blood.

    Roughly 1.3 percent of U.S. residents, from 3 million to 4 million, are infected with hepatitis C, said Jennifer Ruth, a spokeswoman for the CDC. Only a tiny fraction of cases get reported locally to the health district.

    Hepatitis B is serious disease caused by a virus that attacks the liver. It can lead to cirrhosis, liver cancer, liver failure and death.

    Dr. Eugene Speck, director of infectious disease at the University of Nevada School of Medicine, also doesn't think there will be many cases of hepatitis or HIV as a result of this event.

    "They had a syringe that was injected into someone. We're talking about a tiny amount of backflow of blood going into the syringe,'' he said. "That tiny amount goes into a vial. By then it is diluted. It is not a very concentrated amount of blood.''

    "This is just my prediction," he said. "You also have to keep in mind, they've been doing this for four years and we haven't had many cases of hepatitis C in the valley.''

    In general, it is 10 times more likely for a person to contract hepatitis B than HIV; and 100 times more likely for someone to contract hepatitis C than HIV.

    Contact reporter Annette Wells at awells@reviewjournal.com or (702) 383-0283.



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    pam wrote on March 05, 2008 11:36 AM: I am an RN and was a pt at the
    center last on 03/06/07. I am horrified
    that this reuse of syringes was
    permitted by people--nurse anesthetist--who are nurses first like me. They
    are a disgrace to the human race. Revoke their licenses now before they
    are permitted to knowingly harm others. Too bad public pillories are no
    longer around. Dr Desai, leave the US
    now. Go back to the third world country
    you fled in the first place. You have shamed yourself, your fellow doctors, your children and their children . How do you sleep at night? Are you using
    the leftover diprovan vials..dont forget your'e not supposed to reuse the
    syringe,sir. How do you explain your actions to your kids?


    pam wrote on March 05, 2008 11:25 AM: What about the person who has been given the hep b vaccine? Are they protected from Hep c or just Hep b.Please post


    maria rapoport wrote on March 02, 2008 09:55 AM: thank-you for this information in new 5 (Fox) they are saying that the clinic used (reused) syrengis as well as needles if this is misinformation somebody should make them stop as already the people are in a panic. Where the procedures done those days the patients were infected mostly colonoscopies?


    Bob Cirelli wrote on March 02, 2008 05:47 AM: The state board should revoke the licenses of the nurse practitioners and nurse anesthetists who went along with the reuse of syringes. In this day and age they should have known better. After their licesnses are revoked, criminal charges should be brought agains the physicians, and any staff who were involved. There needs to be a message sent. (OTOH it was announced that the physicians who ran the clinic were large contributors to government officials. Time will tell).


    Steve wrote on March 01, 2008 03:45 PM: Is there a website where all of the victims can go? If not, can someone set something up? It would be good to coordinate information. For example, share the name of your nurse and the results of your test? Maybe that would give us an idea of who was doing what. I don't have my results back yet, but my nurse was Linda Hubbard. I hope she was one of the 'good' nurses.

    This has happened before in Oklahoma, Nebraska, New York and Michigan, though not to this scale (www.honoreform.org) Looking at that site, approx. 10% of the victims in each of those cases contracted hepatitus, which means we could be looking at 4,000+ people here. (figures obtained from that website)

    In the 9-1-1 tragedy, around 3,000 people died immediately, surely more afterwards. We go to war and kill thousands in response. Here, 40,000+ people are put at risk, some will certainly have shorter lives and die as a result. Yet our health department doesn't even try to close this place down or go after these guys criminally?

    THANK GOD FOR OSCAR GOODMAN!


    Death nVegas wrote on March 01, 2008 12:58 PM: correction, he says he "doesn't think there will be many cases of hepatitis or HIV" ..which does not tell if he thinks there will be cancers and other viruses breaking out everywhere.


    Death nVegas wrote on March 01, 2008 12:56 PM: If they quoted him accurately in this article, that Dr. Eugene Speck guy at UNLV is a quack too. Got to love that "very tiny amount" stuff. It only takes 1 cancer cell (that's 1 as in not-visible-to-the-human-eye) to convey cancer from one patient to another this way.


    David Johann wrote on March 01, 2008 09:57 AM: Charge Dr. Desai with criminal negligence and seize his passport.


    shut down all their locations wrote on March 01, 2008 08:40 AM: SHUT DOWN ALL THEIR LOCATIONS


    your answer wrote on March 01, 2008 08:38 AM: I was under the impression I was be treated by a doctor anesthesiologist. I am looking for my separate bill that said anesthesiologist on it.

    Last week my mother went there for a follow up procedure. These people never mentioned to her anything about this problem. The first procedure was done in 2006. She ended up in ICU. Her insurance sent her back to the place last week.


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