Now Available
HMA's Pamphlet
Are You At Risk for Hepatitis C? 
Find Out- Free "In Home" Test kit

A Call to Action
 

World Hepatitis Alliance Election Fraud?
Read more... USA Advocates question election for N America's Represenative...

Federal Funding Oversight

Please sign Petition-Office of Government Ethics investigation into HCV research funding

Centers for Disease Control Goals For HCV-.....The goals of hepatitis C prevention and control efforts are: 1) to reduce the incidence of new infections by reducing HCV transmission;
 

Why merging HCV into the growing HIV/AIDS programs hasn’t worked and will not work.

Public Health’s Centers for Disease Control (CDC) HIV program collaboration and service integration fail to meet all the needs of a component prevention program. CDC's grants and cooperative agreements are the main mechanisms for funding HIV, STD, and viral hepatitis prevention activities. Therefore, support for program integration required modifications to the nature and form of funding agreements to reflect priorities. Resources are leveraged from other sources within the agency and from external sources, such as other federal agencies and public/private partnerships. Legislation in the Ryan White Care Act mandates that these grants are specific for HIV disease which includes hepatitis C. Through program collaboration, any identified patient is referred for vaccination, treatment and/or counseling.

Standard elements are used as indicators to monitor program outcomes to ensure the integration design works. The elements have clear intent to prioritize funding for programs that implement or follow narrowly defined practices.

Although integration efforts offer a compelling and powerful approach to prevention, control and regulation of infectious diseases, especially reaching populations at highest risk for disease transmission and acquisition; it lacks the ability that component programs have in  appraisal and regulation of health risks that do not fall within the perimeters of HIV disease spread. Discrimination is fostered for access to health services and medicines.

Eight years after implementing the National HCV Prevention Strategy plan, indicators have failed to identify the majority of previously infected patients for services. These guideline also inadvertency contribute in the lack of public health safety for identifying the source of outbreaks for Dental and Health-care associated hepatitis C infections because screening evaluations fail to identify risks other than HIV related.

From 2004-2009, over 140,000 notification letters were sent throughout the USA. Clinical setting included multiple Veterans Affairs Medical Centers, Public and Private Medical Centers, Cardiology Clinics, Endoscopy and Ambulatory Surgery Clinics, Hematology and Oncology Clinics, Pain Remediation Clinic and Private Physician's Office, Nuclear Imaging Centers and Urology Clinic, Nursing Homes and Assisted-living Facility. The notifications recognized equipment and or injection environments as sources of HCV infections because the facilities did not met public health safety standards.

These outbreaks were identified primarily through clusters of temporally related cases detected by routine viral hepatitis surveillance, a method that underestimates the magnitude of transmission. Surveillance for viral hepatitis typically is passive, with little or no capacity to investigate cases suggestive of transmission during health care and determine their cause (4). Among persons with acute HCV infections, 60%--70% are asymptomatic (2). Additionally, currently available laboratory tests cannot distinguish acute from chronic HCV infection, which makes identifying newly acquired cases difficult.

The most notable, in January 2008, 6 clusters of acute HCV infections came to the attention of the Las Vegas Southern Nevada Public Health District (SNHD). During the investigation, patients were asked by investigator asked about new tattoos, blood transfusions, sexual contact — and then got what would later become a crucial clue that remained dormant for weeks. By accident one investigator overheard a colleague ask her boss for advice on the first HCV case, “should it be noted that the patient had undergone a colonoscopy?” To deliver the news, investigators didn’t have far to go. The Endoscopy Center was across the street— a street thick with medical services clustered around two of the valley’s largest hospitals. 

The cases soon became part of one of largest public health notifications in the USA history.  Notices sent to some 60,000 patients urged testing for HCV. SNHD typically confirms four cases of acute HCV and 20 to 40 chronic cases daily. However, by April 2008, SNHD reported over 200 people were testing positive for chronic infections, a steady increase over several years.

Local officials had known there was a problem for some time but were unable to identity the reason why because of the HIV guidelines that are designed to prevent such occurrences. In 2005, a Public Safety report indicated local cities are facing an estimated $2.8 billion liability over next 30 years- Officials were shocked and left scrambling to identify how to pay for what is expected to be a multibillion-dollar liability due to the surge in reported cases.1


The task of calculating how many people might have been exposed to contaminated procedures and equipment became a math problem. In March 2004, the clinic increased its volume by adding a second procedure room. Logs showed that administrators bought medicine in bulk — in 20 cc or 50 cc single-dose vials. Going back to March 2004 it was clear that there were many more patients than vials of anesthetic. The conclusion: Through spot inspections SNHD found 13 surgical clinic staff re-using vials of medicine and syringes and had been for years. However, notifications were sent to only those attending March 1, 2004, through January 11, 2008.

To date, the SNHD has potentially linked more than 100 cases of hepatitis C to the clinics; though it cannot say how many more remain undetected. The Nevada governor defended the Endoscopy Center saying, if the doctors and nurses there had been grossly negligent, more cases of hepatitis C would have been discovered by now. 2,3

Limited by the costs of the tests, the comprehensive screening evaluations, that failed to detect and identity the outbreaks were once again, based on HIV disease risk guidelines . These guideline disqualified candidates from testing through questionnaires that identify previous at risk HIV “only” behaviors; Blood transfusion, Injecting-drug use, employment in patient care, exposure to a sex partner, household member, multiple sex partners of from a low socioeconomic level. Even though it is well established HCV does not transmit sexually with any efficiency, the majority of cases contracted by blood to blood contact, many candidates were disqualified based on inapplicable methods, proving that HIV program collaboration and service integration failure.

HCV is 100 times more infectious that HIV, just as infectious as HBV according to the World Health Organization. Yet, the battle for funding control through private partnerships continues to manipulate USA and global public health efforts.

Reference:

1  PUBLIC SAFETY PERSONNEL: Benefits report shocks officials

2  Gov. Gibbons lashes out at news media Reacts to health clinic scare

3  Testimony to Legislative Committee on Health Care but has been getting up to 150, officials said

UPDATE: Tip of the Iceburg- more clusters in NV Lawyers suing the Endoscopy Center of Southern Nevada say they have discovered a new cluster of hepatitis C cases that originated at the clinic and predict the discovery will have a big impact on the massive litigation over the outbreak...“This is just the tip of the iceberg,” attorney Will Kemp said Tuesday. “I think we’re going to find more and more clusters as we go forward.” ...

Contact us:
HMAwareness@aol.com