Hepatitis C: Nightmare in Vegas

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Melissa Conrad Stöppler, MD

Trust is a word that is used casually by many people, but when it comes to seeking medical care, we need to believe and trust in our doctors and nurses. To provide care to their patients, they are given access to our bodies and our stories so that they can offer care and help. When that trust is violated, it affects not only that one patient, but it questions the whole system.

Such may be the case in Las Vegas, when patients at a clinic that performs endoscopy procedures were infected with the hepatitis C virus. It seems that personnel at the clinic used unsafe practices when it came to giving medications while performing procedures. It is reported that the contamination came from syringes that were reused on multiple patients. As well, anesthetic drugs packaged for single patient use were given to multiple patients. Dr. Lawrence Sands, the chief medical officer of the Southern Nevada Health District, said that the unclean and unsafe injection practices had been going on for years.

Hepatitis C is a virus that is spread by body secretions, most often by blood. The majority of cases in the world now occur because intravenous drug abusers share needles. In developing countries blood transfusion can be the source of hepatitis C infection. In the US, donated blood is screened for hepatitis C and many other viruses, making transfusion a safe procedure.

Hepatitis C is an unfair disease because the initial infection may cause only minimal symptoms like fatigue or malaise. Some people may have no symptoms at all. But the virus can lay dormant in the body, and in about one-third of patients who aren't treated, can lead to chronic liver damage and cirrhosis. Once detected, antiviral drugs can limit the potential damage and in some cases clear the virus completely from the body.

Of course, if hepatitis C contamination is present, there is also the risk of other viruses coming along for the ride, including hepatitis B and HIV, the virus that causes AIDS; one more worry for those patients who were infected in Nevada. And imagine the worry that all the other patients at the same clinic must have since this discovery became public. Finding all the patients that used the clinic and then testing them for hepatitis viruses and AIDS will keep the public health department and their labs busy for quite a while.

We trust many things in this world. We trust restaurants to be clean. We trust the lawn service people to use safe chemicals. We trust babysitters and school teachers to care for our children safely. Our society is based on trust. And medicine, more than any field, needs the trust of the public. When we lose that trust, it has to be earned all over again, one patient visit at a time.

References: www.msnbc.mns.com, "Hepatitis C fear for thousands in Nevada." February 29, 2008. klsas-tv.com, "Vegas Clinic Patients May Have Been Exposed to Disease." February 28, 2008