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June 30. 2012 11:49PM
NH shouldn't stand alone: Lesson from Exeter hepatitis
The story of the hepatitis C infections at Exeter Hospital is long and complicated and yet to be fully told. Clearly there are lessons to be learned, but we aren’t sure state public health officials are open to learning them.
Staff reporter Shawne Wickham, in one of several fine pieces of reporting, learned that New Hampshire is the only state in the nation that does not require physicians to report hepatitis C cases. There are many areas in which we are glad New Hampshire stands alone. This isn’t one of them.
State Health Director Dr. Jose Montero said that not all cases of the highly infectious disease are diagnosed because only eight of 10 people who have it develop symptoms and others may be drug users.
“Most patients are missed,” Montero said. “That’s why the value of having it reportable is highly debatable.”
Come again? Even if not all reportable cases are reported, the requirement makes sense.
Our reporter learned that this is how the State of Colorado was able to quickly identify the source of just such an outbreak among patients of a Denver hospital.
Colorado, in fact, interviews anyone diagnosed with acute hepatitis. When two cases showed up at the same time in 2009, the state was able to quickly determine that the patients had no normal risk factors, such as injection drug use.
“And they had both had a surgical procedure at the same facility in a time frame that made sense with their infection,” explained Dr. Lisa Miller, Colorado’s state epidemiologist. Turns out a surgical technician at the hospital had recently been let go because of suspected drug use.
That is precisely the circumstance believed to have occurred in Exeter, where cardiac patients, now numbering at least 20, have tested positive for hepatitis C.
It took weeks for Exeter and state officials to figure out what was going on. Would more have been known, sooner, had reporting been required? Perhaps not, but why not increase the chances of discovery?
Dr. Montero’s department has a long list of reportable diseases, everything from AIDS to tetanus. It even includes several strains of hepatitis. Adding infectious hepatitis C to that list seems a no-brainer. We don’t understand why Montero is rejecting the idea. His bosses should reconsider.
Staff reporter Shawne Wickham, in one of several fine pieces of reporting, learned that New Hampshire is the only state in the nation that does not require physicians to report hepatitis C cases. There are many areas in which we are glad New Hampshire stands alone. This isn’t one of them.
State Health Director Dr. Jose Montero said that not all cases of the highly infectious disease are diagnosed because only eight of 10 people who have it develop symptoms and others may be drug users.
“Most patients are missed,” Montero said. “That’s why the value of having it reportable is highly debatable.”
Come again? Even if not all reportable cases are reported, the requirement makes sense.
Our reporter learned that this is how the State of Colorado was able to quickly identify the source of just such an outbreak among patients of a Denver hospital.
Colorado, in fact, interviews anyone diagnosed with acute hepatitis. When two cases showed up at the same time in 2009, the state was able to quickly determine that the patients had no normal risk factors, such as injection drug use.
“And they had both had a surgical procedure at the same facility in a time frame that made sense with their infection,” explained Dr. Lisa Miller, Colorado’s state epidemiologist. Turns out a surgical technician at the hospital had recently been let go because of suspected drug use.
That is precisely the circumstance believed to have occurred in Exeter, where cardiac patients, now numbering at least 20, have tested positive for hepatitis C.
It took weeks for Exeter and state officials to figure out what was going on. Would more have been known, sooner, had reporting been required? Perhaps not, but why not increase the chances of discovery?
Dr. Montero’s department has a long list of reportable diseases, everything from AIDS to tetanus. It even includes several strains of hepatitis. Adding infectious hepatitis C to that list seems a no-brainer. We don’t understand why Montero is rejecting the idea. His bosses should reconsider.
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