The announcement in February 2008 of a hepatitis C outbreak in southern Nevada prompted thousands to face their fear of needles. Notices sent to some 60,000 patients urged testing for HIV, hepatitis B and C after local health officials discovered unsafe injection practices at three local endoscopy centers.
To date, the Southern Nevada Health District has potentially linked more than 100 cases of hepatitis C to the clinics, though it cannot say how many more remain undetected.
"This is one number we know we're just not going to have," said Senior Epidemiologist Brian Labus with the SNHD. "We know there were tens of thousands of people getting tested, but we can't say what percentage got tested from our clinic population, what percentage were positive out of those. We just don't have enough information to be able to put all the pieces together to come up with that actual number."
Labus explains limited information provided by the endoscopy centers makes it next to impossible to isolate clinic patients from others seeking testing. And though the SNHD tracks every positive result, negative tests are not reported.
Frustrated by a lack of information, five months into its investigation the district launched a voluntary exposure registry. Fewer than 15-percent of clinic patients enrolled. "We're not going to find every single person who was infected at the clinic. One of the challenges we have is people are infected. They know they're positive. Trying to figure out where they were infected is another major problem," said Labus.
It's a big problem for Labus and for legions of lawyers suing on behalf of former patients -- many who have advised their clients not to cooperate with the health district. Attorney Ed Bernstein says he is not among them, but he understands the strategy. "Don't forget, the attorneys for the endoscopy center, their interest is to find any little thing that you may have done in any time in your life that would somehow be a risk factor for hepatitis C, other than the clinic," he said.
More than a year and a half after the announcement from an auditorium at the health district, Labus prefers to focus on its outcome and not its shortcomings. "We figured out what was going on. This extra information would be nice, it paints a more complete picture, but it's not necessary for us to say what really happened," he said.
Labus says despite all the scrutiny of this crisis, he still hears from patients who recently learned about it and want to know what they should do.
