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Hepatitis C Outbreaks: When Our Medical System Fails Us

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Silvia Price

Since we keep track of veterans exposures, we noticed that exposures that happened in VA facilities were not included in the CDC’s report so we asked them why. Dr Nicola D.Thompson from the Epidemiology and Surveillance Branch, Division of Viral Hepatitis said…. “For the purposes of this review, we only counted outbreaks of HBV and HCV infection that involved 2 or more infected persons and that could be EPIDEMIOLOGICALLY linked to a specific health care facility” In other words, the CDC only counts the outbreaks if phylogenetic analysis proves that the virus from two or more patients are genetically identical and they can somehow be linked to the clinic. Like if a staff member also has Hepatitis C and the virus is identical to theirs. Phylogenetic testing is very expensive and is usually done only in studies. Besides that, exposures that happen in federal facilities (like VA clinics and prisons), don’t have to be included. Federal facilities make their own rules and deal with exposures any way they want. Take for example, the Dayton Dental Clinic. The 42 page report of the investigation done by the VA says that “repeated violations to infection control guidelines resulted in MASSIVE EXPOSURE of veterans to potential blood born pathogens.” (during fiscal year 2010 the Dayton dental clinic saw 3,142 veterans and had 11,400 visits, multiplied by 18 years of exposure ). The report also said that they also let dental residents practice on veterans without supervision like is required by law. The dentists took credit for the visits (so they could charge for them) and they wrote the notes on the charts without seeing the patients or discussing the cases with the residents. Based on those notes, the VA decided that only 535 veterans had "invasive procedures" and needed to be tested for Hep B, C and HIV. As if the wasn't bad enough, the CDC didn't even include the exposure on their report. I totally agree with Ian Blenkharn, a microbiologist with 30 years of experience with the NHS and UK universities and an expert witness for the UK’s High Court, who said, "The CDC’s guidelines as well as OSHA guidelines were created to protect ALL patients and should be applied at ALL times and not just on a selective basis. Since all of those rules and regulations require a uniform standard of hygiene performance, exemplified in the CDC’s Universal and Standard Precautions, then it becomes hard to argue that somehow the universality of protection in this case might be downgraded to be in some way conditional and only include 535 people of the thousands exposed.”

July 1, 2014

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