Familiar face answers call for help resolving endoscopy center crisis

Dr. Mary Guinan spent 20 years with the federal Centers for Disease Control and Prevention investigating and tracking deadly infectious diseases such as AIDS and smallpox.

On Thursday, she became Nevada's acting chief public health officer and will be charged with getting to the bottom of the hepatitis C outbreak and keeping Nevadans healthy.

"How is it possible in this day and age, in infection control?'' Guinan asked about the link health officials have made between seven hepatitis C cases and medical practices at two Southern Nevada endoscopy centers. "That's what I am going to try to find out.''

Guinan's comments came hours after Gov. Jim Gibbons announced she would be taking the job. She held the chief public health officer's position from 1998 to 2002; the position had been open since Dr. Bradford Lee retired in June.

The first task for Guinan -- along with the Southern Nevada Health District -- is to ensure the 40,000 patients who were warned to be tested for hepatitis C and HIV are located. Health officials then must identify those who test positive and direct them to the appropriate care.

Six people are believed to have contracted hepatitis C last year at the Endoscopy Center of Southern Nevada at 700 Shadow Lane as a result of unsafe injection practices.

A seventh case was linked to Desert Shadow Endoscopy Center at 4275 S. Burnham Ave. However, the health district has yet to determine if a second wave of notifications needs to be sent out to those patients, because their records are in the possession of the Metropolitan Police Department, which is conducting a criminal investigation.

Guinan said there's a disconnect among agencies handling pieces of the hepatitis C investigation. She plans to make sure each agency has access to the same information at the same time.

"In public health you have to be an optimist. We have to make changes,'' said Guinan, whose work on the CDC's AIDS Task Force involved interviewing some of the nation's first AIDS patients.

"As a state health officer, I have the power to enact regulations if there is an emergency,'' she said. "With this situation now, I don't think I will have to do that. But the power is there.''

Maurizio Trevisan, vice chancellor and chief executive officer of the University of Nevada Health Sciences System, said Guinan is the right person for the job because she has "energy, passion and is inspiring.''

Gibbons expressed confidence in Guinan at a Thursday news conference, saying, "She brings forward a great deal of background and experience that's going to be very helpful for the state."

Asked whether the position's vacancy had affected the state's ability to respond to the crisis, Gibbons said flatly, "No, I do not.''

Guinan, dean of UNLV's public health department, said she was surprised when the state's Health Division called her about leaving her position to take over as the health officer.

Guinan, who earned her medical degree from The Johns Hopkins University in Baltimore, Md., said she spoke with UNLV's provost and president about taking the job. She said accommodations were made to let her stay on as dean as well as perform the duties of acting state health officer.

Guinan on Thursday held conference calls with the health district and the state's Health Division to discuss how they are collaborating.

She plans to speak with CDC officials today to determine their role in the investigation and to seek out resources, such as experts to develop a panel on infectious disease control practices.

"This is not unique to Nevada. I plan to contact state health officers in Nebraska and New York and other states where there have been outbreaks to find out what they did and how they solved the problem. We want to learn from their experience.''

Guinan plans to review results of the state's Bureau of Licensure and Certification inspections of all 50 ambulatory surgery centers. Such facilities are a relatively new concept in the nation, she said.

"These are high volume medical care facilities. And we don't know enough about them. We have to figure out how to regulate them, as opposed to how we regulate hospitals and nursing homes.''

Before Guinan joined the state health division in 1998, she was a physician and scientist at the CDC for 20 years.

During her previous stint as Nevada's chief health officer, Guinan worked on fluoridating Nevada's water supply and helping to investigate the leukemia cluster in Fallon.

Review-Journal writer Molly Ball contributed to this report. Contact reporter Annette Wells at awells@reviewjournal.com or (702) 383-0283.