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Dentist's office a 'perfect storm' for HIV, hepatitis exposure - CNN.com- About 7,000 patients who visited a suburban Tulsa, Oklahoma, dentist in the past six years may have been exposed to HIV and hepatitis, health investigators say. Investigators were left grasping for words to describe what they found inside W. Scott Harrington's dental practice: Assistants did techniques that only a dentist should, and sterilization procedures and needles were handled improperly.
"I will tell you that when ... we left, we were just physically kind of sick," said Susan Rogers, executive director of the Oklahoma Board of Dentistry. "I mean, that's how bad (it was), and I've seen a lot of bad stuff over the years."
"I knew the stigma" that came with a hepatitis diagnosis, Nguyen said. But he thought that a medical school, of all places, would understand. "I came there expecting help. Instead, I was greeted with discrimination." Nguyen's prospects of becoming a physician are a lot brighter today. The U.S. Department of Justice recently declared in a legal settlement that hepatitis B patients are protected by federal disability law. And, separately, federal health officials have issued a revised set of guidelines that make it clear that health care workers and students who carry the hepatitis B virus HBV for short generally pose little or no risk to patients.
Taken together, advocates say, the new health guidelines and the Justice Department settlement remove barriers to practice, handing HBV-positive health professionals and students a pair of powerful tools to combat discrimination. "It gives us so much more leverage. We no longer have to wring our hands," said Joan Block, executive director and co-founder of the Hepatitis B Foundation, a nonprofit in Doylestown, Pa. She said Nguyen was among several students who contacted the foundation in 2011 to report they'd either been forced out of school, or had their admissions rescinded, because of an HBV diagnosis.
Hepatitis B is a contagious and potentially fatal liver disease spread through blood and other bodily fluids. The virus that causes it is most commonly transmitted through unprotected sex. Intravenous drug use is another major risk factor. It can also be passed from an infected mother to her baby at birth, which is how Nguyen contracted it. Even though he'd been vaccinated as a child, the virus was already in his body. As many as 1.4 million Americans have chronic hepatitis B. It's not clear how many of them are health practitioners. But some 25 percent of medical and dental students and many practicing doctors, surgeons and dentists were born to mothers from countries in Asia and other regions of the world where the virus is endemic, according to the U.S. Centers for Disease Control and Prevention.
The CDC last issued guidelines for management of health workers and students with hepatitis B in 1991. A lot had changed in two decades. Universal infant vaccination had slashed the number of new cases by more than 80 percent. New drug therapies had proved effective at reducing the amount of virus in a carrier's blood to very low or undetectable levels, greatly minimizing the risk of transmission. And there had been only a single case of hepatitis B transmission from a health provider to a patient at least since 1991 an orthopedic surgeon who was unaware of his hepatitis infection and had a very high amount of the virus in his body. He infected two to eight patients, according to the CDC. While the old guidelines stated that a hepatitis B diagnosis by itself shouldn't preclude doctors, dentists, nurses and other health professionals from seeing patients, "we were concerned that with a 20-year-old set of guidance, it was not really considered as relevant as it could be," said Dr. John Ward, director of the CDC's Division of Viral Hepatitis.
More Feds: Hepatitis B no barrier to health practice
This happened a while ago. Been in a coma or something?
The Springfield-Greene County Health Department announced Wednesday that a Red Robin restaurant reported that a worker had the liver disease. People who visited the restaurant between May 8 and May 16 can receive the immunizations. Officials told The Springfield News-Leader (Up to 5,000 exposed to hepatitis A at restaurant) that customers must be vaccinated within 14 days of their possible exposure for the vaccination to work.
Kathryn Wall, a spokeswoman for the health department, said people may have been exposed as early as May 4, although she could not estimate how many. "Those individuals should monitor their health and report symptoms to their health care providers," she said. Wall said the sick worker was a server, and that the Health Department has not confirmed any new hepatitis A cases. Health officials said the Red Robin is now safe to visit.
Allyson Tuckness and her husband, Chris, ate at Red Robin on May 16 with their toddler, Mason. She said their son has already had vaccinations against hepatitis A. "I'm annoyed that it happened but glad we found out during the incubation period," Tuckness said.
Hepatitis A infects the liver, and can result in a mild illness lasting a few weeks to a severe illness lasting several months, according to the U.S. Centers for Disease Control and Prevention. It spreads through consuming fecal matter, which makes it different from hepatitis B and C, which spread through blood and body fluids. It's also generally milder than the other two rarely fatal, and most people experience no lasting liver damage.
Up to 5,000 exposed to hepatitis at Mo. restaurant | CNS News
The medicines, which are highly effective against hepatitis C, may trigger latent hepatitis B in patients infected with both types, the European Medicines Agency said in a statement. It named the antivirals Daklinza, Exviera, Harvoni, Olysio, Sovaldi and Viekirax used to treat chronic hepatitis C, an infectious liver disease. "Cases of the return of previously inactive hepatitis B infection, which can be fatal, have been reported in patients treated," with this class of drug, the agency said in a statement announcing the findings of a probe.
There have been only about 30 cases of hepatitis B reactivation out of thousands of patients taking the drugs, the agency said. And there was not enough information to draw a conclusion on cancer risk. But a special risk assessment committee of the agency recommended that all patients be screened for hepatitis B virus before starting any of these treatments. It also proposed that a warning be included in the drug information leaflet. The drugs, a new class known as "direct-acting antivirals" are more effective than their predecessors.
At a cost of some 40,000 to 80,000 euros ($43,000-$86,000) for a 12-week course, they are the preserve of a lucky few. Hepatitis is an inflammation of the liver, most often caused by a virus but sometimes by drug or alcohol abuse, other infections, or autoimmune diseases. The B and C types usually occur from contact with body fluids of an infected person. Other than for hepatitis B, there is no vaccine against hepatitis C.
Drug for one hepatitis type may activate another: watchdog
