Another CDC expert backs officials' conclusions in hepatitis outbreak

One of the country’s top hepatitis C experts on Thursday supported health officials who concluded that the 2007 outbreak of the deadly virus in Las Vegas was the result of unsafe injection practices.

Miriam Alter, a retired top hepatitis epidemiologist at the U. S. Centers for Disease Control in Atlanta, testified that she shares the finding that the combination of reusing syringes in bottles of the anesthetic propofol on multiple patients spread the blood-borne virus.

Her testimony came as prosecutors continued to wind down their criminal case against Dr. Dipak Desai and nurse anesthetist Ronald Lakeman.

The two defendants are standing trial in the courtroom of District Judge Valerie Adair on more than two dozen charges stemming from the outbreak, including second-degree murder, criminal neglect of patients, theft and insurance fraud.

The charges focus on the cases of seven hepatitis C infections health officials linked to Desai’s now-closed Endoscopy Center of Southern Nevada. One of the patients, Rodolfo Meana, died last year.

On Monday, Brian Labus, the Southern Nevada Health District’s chief epidemiologist, reiterated on the witness stand his 2009 conclusion that the outbreak was the result of unsafe injection practices.

In earlier testimony, CDC physicians who assisted the local investigation backed the theory advanced by Labus.

Defense lawyers have maintained that the virus could have spread through the contamination of saline containers used on multiple patients or through flaws in the cleaning of scopes and biopsy equipment.

But Alter, who left the CDC in 2006 after 25 years of investigating hepatitis outbreaks across the country, said Thursday she joined Labus in discounting those claims.

Alter testified that unsafe injection practices generally have been the source of hepatitis C outbreaks at other outpatient clinics over the years. She cited cases similar to Las Vegas in New York in 2001 and 2007 and in Oklahoma in 2002.

On cross-examination, Alter acknowledged that her opinion of the cause of the Las Vegas outbreak does not come from her participation in the investigation, but rather from reading reports and a scientific article written by her former colleagues.

She called the injection practices at Desai’s clinics “unfortunate.”

Alter testified as an expert witness to help prosecutors wrap up their case, which began more than seven weeks ago.

Prosecutors hope to rest on Friday.

Robert Whiteley, the lead detective in the massive outbreak investigation, is to take the witness stand for the first time in the case.

Contact Jeff German at jgerman@reviewjournal.com or 702-380-8135. Follow @JGermanRJ on Twitter.