/Health District Identifies 105 Potential Clinic Associated Hepatitis C Infections

Health District Identifies 105 Potential Clinic Associated Hepatitis C Infections

October 23, 2008

LAS VEGAS – The Southern Nevada Health District has classified 101 cases of chronic hepatitis C infection as possibly associated with the Endoscopy Center of Southern Nevada, 700 Shadow Lane, and four cases possibly associated with the Desert Shadow Endoscopy Center, 4275 Burnham Avenue. The number of hepatitis C cases directly linked to the clinics remains at nine.

To date, the health district has received 7,331 Hepatitis C Exposure Registry enrollment forms since its implementation in June. Information received by contacting patients with positive laboratory reports and patients who were part of the case investigations were also entered into the registry database.

Laboratory confirmed patients with verified procedure dates, no identified risk factors and no history of positive laboratory reports were classified as “possibly associated.” The health district classified 35 laboratory confirmed cases as “indeterminate” if the patient reported having one or more of the risk factors associated with hepatitis C infections. This classification does not rule out possible infection at the clinic. However, the health district cannot make any further determination because of the presence of other likely sources of infection.

The evaluation of chronic hepatitis C infections involves examining a patient’s risk over a lifetime. The evaluation of acute hepatitis C infections involves examining a patient’s risk for six months prior to the onset of symptoms. To evaluate patients’ risk factors and to determine if their infection was related to the clinic, the health district developed a set of criteria to classify cases based on whether they were chronic or acute. In addition, classifications about the likelihood that the patient was exposed at the clinic were developed to help investigators better understand patient risk factors prior to having a procedure at the clinic.

“The registry, the interviews, and the criteria developed to identify and classify cases provided the investigators with important information to help us better understand the scope of this outbreak. This is the largest disease investigation that our health district has undertaken and we recognize the importance of sharing these results with the community,” said Dr. Lawrence Sands, chief health officer. “The identification of these additional cases as well as the identification of the source cases from July and September reinforces our longstanding recommendation for patients of the clinic to get tested for possible infections.”

In July, the health district reported that it identified two source cases related to the Endoscopy Center of Southern Nevada outbreak. One patient had a procedure on July 25, 2007, and the other on September 21, 2007. These are the dates that disease transmission was known to occur.

Results of genetic testing allowed the health district’s epidemiology team to positively identify the two individuals as the source cases among clusters of patients who underwent procedures on the same dates. Samples were tested by the Centers for Disease Control and Prevention (CDC).

Information about the hepatitis C outbreak, including the health district’s Interim Report on the outbreak, is available on the website, www.SouthernNevadaHealthDistrict.org.

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The Southern Nevada Health District serves as the local public health authority for Clark County, Boulder City, Henderson, Las Vegas, Mesquite and North Las Vegas. The agency safeguards the public health of the community’s residents and visitors through innovative programs, regulations, and initiatives focused on protecting and promoting their health and well-being. More information about the Health District, its programs, services, and the regulatory oversight it provides is available at www.SNHD.info.