Staff error caused hepatitis outbreak

The area's first known group outbreak of hepatitis C was isolated to mistakes made by an employee at a Brandon holistic medical clinic, public health officials say.

Up to eight patients at Wellness Works, 1209 Lakeside Drive, have tested positive for the blood-borne illness, which is most often transmitted by the improper sharing of needles or intravenous medical equipment. Since the Hillsborough County Health Department launched an investigation in July, nearly 130 patients have been tested.

No more patients tested positive since The Tampa Tribune first reported the outbreak in February.

Epidemiologist David Atrubin said patients were infected during one week in mid-April, the result of an employee failing to follow standard procedures when "preparing and administering intravenous therapy." The treatments resumed after repeated inspections of equipment and operating procedures, Atrubin said.

"We don't have any reason to believe there was any transmission after that point in mid-April," he said. The case remains under investigation.

Clinic responds to outbreak

Wellness Works specializes in holistic medicine, including the administration of vitamin and toxin removal therapies through intravenous solutions. The clinic made staffing changes as a result of the investigation, including the addition of employees to oversee intravenous treatments called chelation. The clinic's director could not be reached for comment.

The outbreak is the first known case of hepatitis C infection through a Tampa Bay area medical clinic, Atrubin said. Most often, hepatitis C is not contracted in clusters and instead involves one individual infecting another.

However, the Brandon case joins a growing number of high-profile cases across the country in which medical mistakes infected patients with the incurable liver disease that often lies dormant for months or years. The national Centers for Disease Control and Prevention says up to 80 percent of the 3.2 million people in the United States with chronic hepatitis C do not know they are sick.

Errors lead to exposure

In 2009, up to 10,000 Veterans Administration patients in Miami, Murfreesburo, Tenn., and Augusta, Ga., were exposed to HIV, hepatitis C and hepatitis B infection. Improper operation and sterilization of equipment for common endoscopic and minimally invasive procedures is suspected in the infection of more than 50 veterans, including 34 with hepatitis C.

The mistakes led to Congressional hearings this past summer, which highlighted lax procedures at some of the 153 VA medical centers. There it was revealed that surprise inspections at 42 VA sites found 57 percent of the centers had inadequate operating procedures and improperly trained staff. The James A. Haley Veterans Hospital in Tampa and the Bay Pines VA Medical Center in St. Petersburg were not part of the inspections.

So far this year, 263 new cases of hepatitis C have been diagnosed in Hillsborough County. Health department records show nearly 1,400 new cases a year are diagnosed.

Long-term consequences

Though hepatitis C shows few outward symptoms, its long-term consequences are severe. The CDC reports that 60 to 70 of every 100 people with chronic hepatitis C will have chronic liver disease, up to 20 will develop cirrhosis and up to five will die from cirrhosis or liver cancer.

Hepatitis C is one of three major hepatitis viruses. Hepatitis A is an acute virus, which means it disappears over time. In 2002, three children at a Tampa preschool were infected with hepatitis A, which is spread when a person ingests fecal matter, even a microscopic amount.

Hepatitis B and C both start as an acute infection but can morph into a chronic illness. Children with hepatitis B are more likely than adults to develop a lifelong condition. With hepatitis C, 15 percent to 85 percent of all people infected will deal with chronic illness.