Southern Nevada Identifies Source Cases For Hepatitis C Outbreak
The Southern Nevada Health District has identified two source cases related to the hepatitis C outbreak at the Endoscopy Center of Southern Nevada, 700 Shadow Lane. 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. An additional chronic (non-acute) case of hepatitis C infection has also been linked to the September 21 source case. The health district can now link a total of eight hepatitis C cases directly to the Endoscopy Center on Shadow Lane and one acute case to the Desert Shadow Endoscopy Center, 4275 Burnham Avenue.
As part of the investigation, genetic testing was performed to determine if the hepatitis C cases on these two days are linked. The testing and results of the epidemiologic investigation allowed the health district’s epidemiology team to positively identify 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).
“These results will help us to better understand how the disease was transmitted on those days and supports the initial findings of our investigation,” said Dr. Lawrence Sands, chief health officer. “It is important for us to remember that this outbreak is not the result of any actions on the part of the patients, but it is the result of unsafe practices by the staff of these clinics.”
The health district previously reported the identification of 77 cases of hepatitis C infections that are considered potentially associated with the Shadow Lane clinic. These patients had different procedure dates, and the health district will not be able to perform genetic testing for these cases because there is no identified source for comparison. No additional cases have been identified in the investigation of the acute case related to the Burnham Avenue clinic, and a source case cannot be identified. This patient was diagnosed in 2006 and the case was not reported to the health district until March of this year.
In June, the health district announced the development of the Hepatitis C Exposure Registry. The registry was developed to assist in the identification of patients who had procedures at both clinics, including those who are infected with the hepatitis C virus, and allows patients who have tested positive to learn their case classification. To date, the health district has received 6,000 completed enrollment forms for the Hepatitis C Exposure Registry.
“We are very encouraged by participation in the registry,” said Sands. “Patients are providing us with important information about their procedures, their test results, and health status. The registry will allow us to identify additional cases or exposures at either clinic.”
In early June, former patients of the Endoscopy Center of Southern Nevada and the Desert Shadow Endoscopy Center were notified by mail about the development of the Hepatitis C Exposure Registry. Patients who wish to enroll in the registry can obtain forms at any public health center location or download from the health district website.