Another hepatitis C case has been linked to a shuttered Las Vegas endoscopy center, and it genetically matches strains from a cluster of six cases that prompted the nation's largest patient notification, Southern Nevada Health District officials said Wednesday.
The total number of confirmed cases since health officials announced the outbreak in late February now stands at nine. Unlike the other cases, however, the latest patient to test positive for the disease did not become ill within the six-month incubation period. That means the case is chronic, not acute, hepatitis C.
"This is an individual who was treated at the endoscopy center on one of two days,'' said Jennifer Sizemore, a health district spokeswoman, referring to July 25 and Sept. 21 of last year.
Health district investigators and the Centers for Disease Control and Prevention believe nurse anesthetists on those dates transmitted hepatitis C to the six patients at the 700 Shadow Lane facility after contaminating single-dose anesthesia vials with syringes that had been reused.
According to a CDC report released in May, those patients received anesthesia from one of two nurse anesthetists who reported routinely reusing syringes and medication vials.
One of the nurse anesthetists told health investigators that the practice of reusing syringes and single-dose vials of propofol -- a fast-acting sedative -- reflected what clinic staff had instructed him to do, according to the May report.
Roughly 120 people had procedures on those two days at the facility, officials say.
Another hepatitis C patient linked to the Shadow Lane facility had undergone a procedure in June 2005, developing symptoms within weeks.
Health officials also linked a hepatitis C case to the Desert Shadow Endoscopy Center on Burnham Avenue, which is affiliated with the Shadow Lane facility. The patient had undergone a procedure in 2006, but health officials were not able to determine how the disease was contracted.
Some 40,000 former patients of the Endoscopy Center were urged to be tested for hepatitis strains B and C and for HIV, the virus that leads to AIDS. The notification increased to more than 50,000 patients as health officials acquired more accurate patient records.
Those patients visited the Shadow Lane facility between March 2004 and Jan. 11, the time frame in which officials believe unsafe injection practices took place.
The health district has also sent 13,000 letters to the Burnham patients encouraging them to get tested for blood-borne diseases.
About 400 people who underwent procedures at the Shadow Lane facility have tested positive for hepatitis C. Health officials have previously said there's a possibility 77 of them may have acquired the disease at the clinic.
Also on Wednesday, Gov. Jim Gibbons announced the appointment of Van Hefner to the Nevada State Board of Medical Examiners. Hefner replaces the late Donald Baepler, said Gibbons' press secretary, Ben Kieckhefer.
Hefner is chief executive of the Las Vegas-based Nevada Hotel and Lodging Association and president of Hefner and Associates, a consulting firm.
Baepler, who died after a long battle with cancer, was acting medical board president overseeing proceedings involving the outbreak.
Contact reporter Annette Wells at firstname.lastname@example.org or 702-383-0283.