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June 23. 2012 8:50PM
Montero says more hepatitis C victims are possible
While no new cases of hepatitis C turned up in testing last week, the state's public health director says there may yet be other patients identified in the outbreak linked to Exeter Hospital's cardiac catheterization lab.
Dr. Jose Montero has asked medical providers statewide to look at all cases of hepatitis C diagnosed “over the last year or so” to see whether any could be linked to a New Hampshire health care provider. “We haven't seen such evidence,” he said. “Yet.”
Montero has said a hospital employee exposing patients to contaminated syringes is the “only real explanation” for the Exeter Hospital outbreak, which began May 10.
The Centers for Disease Control and Prevention is analyzing blood samples from all Exeter Hospital patients who have tested positive for hepatitis C, Montero said Friday. That includes the 19 patients who have the same strain of the virus as a hospital employee and nine cases involving different strains of the virus.
Montero said those other nine patients could have been infected with the virus under circumstances completely unrelated to Exeter Hospital's outbreak. But he said the CDC is doing additional genetic testing to make sure.
After a similar hepatitis C outbreak in 2009 at a hospital in Denver, Colo., a surgical technician admitted she had been swapping syringes of pain medication with contaminated needles refilled with saline. The woman is serving 30 years in federal prison after pleading guilty to tampering with a consumer product.
Denver attorney Hollynd Hoskins' law firm represented 15 of the 24 patients infected there. She said the hospital employee admitted she had been bringing home syringes and sharing them with other addicts; she later brought back the used syringes to swap for the ones prepped for surgical procedures.
And that may have exposed some hospital patients to hepatitis C from other individuals, Hoskins said.
She said the fact that there are different strains of the virus in some cases that turned up in testing of Exeter Hospital patients doesn't mean they're not related to the outbreak. “The people that aren't the same strain, you can't rule them out,” she said.
If the employee involved was taking needles home and sharing them with other addicts, she said, “It could be somebody else's strain that's on that needle.”
Montero said public health investigators have not ruled out that possibility. That's one reason the CDC is doing the additional testing, he said, “to do some further analysis and see if they can find in those samples that we are calling not linked anything else that we didn't.”
“We have been saying from the very beginning we may have a higher number of cases when we get the results from CDC,” Montero said.
He said his office is also looking at detailed clinical histories of those nine patients to see whether they have any other risk factors for hepatitis C.
As of Friday, the state had received 1,030 blood samples for testing. In addition to the 29 positive cases, there were 962 samples that showed no sign of infection. The rest are still pending.
Montero said about 150 people who were treated at Exeter's cardiac catheterization lab (CCL) since Oct. 1, 2010, still need to be tested. And he said about 100 patients who underwent procedures during that time period have died.
Montero said some patients who have tested negative for the virus will have to be retested, especially those who had procedures done closer to the time the CCL was closed, on May 25. That's because there may not have been enough time for them to have developed antibodies to hepatitis C, which is what the first screening tests detect.
In testing so far, he said, the earliest procedure linked to a positive blood test was done in June 2011.
Montero still will not say whether a hospital employee identified early on as having the same strain of the virus as the infected patients is the target of an ongoing criminal investigation. However, hospital officials have said that employee was suspended in mid-May after the first cases were reported. And Montero said he cannot say whether the suspected employee has worked at other health care facilities in New Hampshire.
The Attorney General's Office and the U.S. Attorney's Office are among federal and state agencies investigating the outbreak. Jane Young, associate attorney general, said Friday there are no new developments in the investigation that can be made public.
Colorado attorney Hoskins said drug diversion by health care workers is both foreseeable and preventable.
The Denver hospital that was sued, Rose Medical Center, settled with all 15 of her clients; the results are confidential. The hospital, Hoskins said, “stepped up to the plate, changed a lot of its policies and procedures ... (and) took care of all of its patients,”
Likewise, in the New Hampshire outbreak, she said, “I would hope that this hospital would not just get in the litigation defense mode but figure out what happened, take care of their patients now, and make changes so it cannot happen again.”
Dr. Jose Montero has asked medical providers statewide to look at all cases of hepatitis C diagnosed “over the last year or so” to see whether any could be linked to a New Hampshire health care provider. “We haven't seen such evidence,” he said. “Yet.”
Montero has said a hospital employee exposing patients to contaminated syringes is the “only real explanation” for the Exeter Hospital outbreak, which began May 10.
The Centers for Disease Control and Prevention is analyzing blood samples from all Exeter Hospital patients who have tested positive for hepatitis C, Montero said Friday. That includes the 19 patients who have the same strain of the virus as a hospital employee and nine cases involving different strains of the virus.
Montero said those other nine patients could have been infected with the virus under circumstances completely unrelated to Exeter Hospital's outbreak. But he said the CDC is doing additional genetic testing to make sure.
After a similar hepatitis C outbreak in 2009 at a hospital in Denver, Colo., a surgical technician admitted she had been swapping syringes of pain medication with contaminated needles refilled with saline. The woman is serving 30 years in federal prison after pleading guilty to tampering with a consumer product.
Denver attorney Hollynd Hoskins' law firm represented 15 of the 24 patients infected there. She said the hospital employee admitted she had been bringing home syringes and sharing them with other addicts; she later brought back the used syringes to swap for the ones prepped for surgical procedures.
And that may have exposed some hospital patients to hepatitis C from other individuals, Hoskins said.
She said the fact that there are different strains of the virus in some cases that turned up in testing of Exeter Hospital patients doesn't mean they're not related to the outbreak. “The people that aren't the same strain, you can't rule them out,” she said.
If the employee involved was taking needles home and sharing them with other addicts, she said, “It could be somebody else's strain that's on that needle.”
Montero said public health investigators have not ruled out that possibility. That's one reason the CDC is doing the additional testing, he said, “to do some further analysis and see if they can find in those samples that we are calling not linked anything else that we didn't.”
“We have been saying from the very beginning we may have a higher number of cases when we get the results from CDC,” Montero said.
He said his office is also looking at detailed clinical histories of those nine patients to see whether they have any other risk factors for hepatitis C.
As of Friday, the state had received 1,030 blood samples for testing. In addition to the 29 positive cases, there were 962 samples that showed no sign of infection. The rest are still pending.
Montero said about 150 people who were treated at Exeter's cardiac catheterization lab (CCL) since Oct. 1, 2010, still need to be tested. And he said about 100 patients who underwent procedures during that time period have died.
Montero said some patients who have tested negative for the virus will have to be retested, especially those who had procedures done closer to the time the CCL was closed, on May 25. That's because there may not have been enough time for them to have developed antibodies to hepatitis C, which is what the first screening tests detect.
In testing so far, he said, the earliest procedure linked to a positive blood test was done in June 2011.
Montero still will not say whether a hospital employee identified early on as having the same strain of the virus as the infected patients is the target of an ongoing criminal investigation. However, hospital officials have said that employee was suspended in mid-May after the first cases were reported. And Montero said he cannot say whether the suspected employee has worked at other health care facilities in New Hampshire.
The Attorney General's Office and the U.S. Attorney's Office are among federal and state agencies investigating the outbreak. Jane Young, associate attorney general, said Friday there are no new developments in the investigation that can be made public.
Colorado attorney Hoskins said drug diversion by health care workers is both foreseeable and preventable.
The Denver hospital that was sued, Rose Medical Center, settled with all 15 of her clients; the results are confidential. The hospital, Hoskins said, “stepped up to the plate, changed a lot of its policies and procedures ... (and) took care of all of its patients,”
Likewise, in the New Hampshire outbreak, she said, “I would hope that this hospital would not just get in the litigation defense mode but figure out what happened, take care of their patients now, and make changes so it cannot happen again.”
