Authorities in southern Nevada said they were notifying some 40 000 patients who received anaesthesia injections at the clinic's endoscopy centre between March 2004 and January 11, 2008 about potential exposure to hepatitis and HIV.

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They recommended in a statement that the patients "contact their primary care physicians or health care providers to get tested for hepatitis C as well as hepatitis B and HIV."

The move comes after several acute cases of hepatitis C showed up in the area. Six people have been diagnosed with the disease since January, which is three times higher than the yearly average for the Las Vegas region.

Patients exposed to blood of other patients
The three first cases came to light in January, and three other patients were subsequently found to have been infected with hepatitis C. Five of the infected people all received anaesthesia injections on the same day in the Endoscopy Centre of Southern Nevada in the sprawling city of Las Vegas.

After an investigation, "the health district determined that unsafe injection practices related to the administration of anaesthesia medication might have exposed patients to the blood of other patients," it said.

"The joint investigation identified the re-use of syringes (not needles) and the use of single dose vials of anaesthesia medication on multiple patients as the potential sources of contamination."

Action has since been taken by the clinic to end such practices. "It appears the injection practices that can lead to the transmission of hepatitis C and other blood-borne infections have been occurring at this clinic for several years," said chief health officer Lawrence Sands.

"We are recommending all patients during this time-frame to get tested because we cannot determine which patients may have been exposed."

Low risk to general public
Hepatitis C can result in severe liver damage, but the symptoms may not show up for several years so even if patients are feeling well they should be tested, he warned. The health authorities added however that the risk to the general population was low as hepatitis cannot be spread by casual contact.

The clinic said in a statement that it has taken corrective measures. "On behalf of the Endoscopy Centre of Southern Nevada, we want to express our deep concern about this incident to the many patients who have put their trust in us over the years," the statement read. "As always, our patients remain our primary responsibility and we have already corrected the situation," officials at the facility said.

"We have already taken steps to ensure that it will never happen again. We want to be sure that every patient who may have been exposed is informed and tested."

The Endoscopy Centre of Southern Nevada said it was working with "nationally renowned experts who have extensive epidemiological experience" on how best to proceed, as it tried to tamp down public fears.

"We wish to emphasise that the actual risk of anyone being affected by this is extremely low, but, as a precaution, anyone who has undergone procedures at the Endoscopy Centre requiring anaesthesia should be tested." – (Sapa) - February 2008

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