Information for Patients
We are urging patients who had surgery and received injected
medication for their procedure at Rose Medical Center between Oct.
21, 2008, and April 13, 2009, to get tested for hepatitis C as they
may have been exposed to the virus by a former health care worker at
Rose who was stealing pain medication for personal use.
The former employee also worked for a short time at Audubon Surgical
Center in Colorado Springs and may have exposed patients undergoing
surgical procedures between May 4 and July 1, 2009. We are urging
these patients to get tested for hepatitis C as well.
Frequently Asked Questions
What is Hepatitis C?
Hepatitis C is an infection caused by the hepatitis C virus that can
result in inflammation of the liver. The virus is spread when an
infected person’s blood comes in contact with another person’s
bloodstream. The virus can be transmitted through blood in needles
or other injection equipment that is contaminated (or tainted) with
infected blood.
How else is hepatitis C spread?
Hepatitis C can be spread from one person to another through
syringes or needles used to inject drugs. In the past, hepatitis C
was spread through blood transfusions before blood banks began
routine screening in 1992.
It also can be spread through contact with very tiny amounts of
blood on shared razors, toothbrushes and other items that may come
in contact with blood.
There is a small chance that it can be transmitted through sexual
contact.
Hepatitis C is not transmitted through casual contact such as
hugging or shaking hands, nor is it spread by an infected person’s
cough or sneeze.
The virus cannot be acquired by drinking out of a glass used by a
person infected with hepatitis C.
What are the symptoms of Hepatitis C?
Hepatitis C is called a “silent infection” because 80 percent of
people may have no signs or symptoms but can still infect others.
Symptoms can develop slowly and may include:
- Loss of appetite
Fatigue
Stomach pain
Nausea
Vomiting
Jaundice (yellowing of the skin or whites of the eyes)
Up to 5 percent of people that carry the hepatitis C virus will
suffer from cirrhosis, chronic liver disease or liver cancer.
How soon do symptoms of hepatitis C appear?
Symptoms may appear as soon as two weeks and as long as six months after
exposure.
How long can an infected person spread the virus?
Infected people may spread the virus indefinitely even if they do
not experience symptoms.
Is there a vaccine for the prevention of hepatitis C?
No. There is no vaccine for hepatitis C.
How were patients exposed in this investigation?
We believe that a terminated employee, a surgical scrub technician,
is responsible for these exposures. The transmission of the disease
resulted from the illegal practices of the former employee who was
stealing pain medication (fentanyl) for personal use, and in the
process potentially exposed patients to hepatitis C. This employee
took syringes containing fentanyl from the operating room, injected
herself, and refilled the syringes with saline solution. These
contaminated syringes then were administered to patients during
surgical procedures. We do not know how often this occurred, but
based on the investigation so far, several patients may have
contracted hepatitis C in this manner. Testing everyone who had a
procedure during the time period that the employee worked may
identify more instances of transmission.
How can I get tested?
Confidential free blood testing for hepatitis C is being provided by
Rose Medical Center and Audubon Surgical Center through a commercial
laboratory. Details and testing locations will be included in
patient notification letters from these facilities.
If you have specific questions regarding testing, please contact
the facility where your surgical procedure was performed. Phone
numbers and Web site links are as follows:
Rose Medical Center: 303-329-7500
www.rosemed.com
Audubon Surgery Center: 719-571-4440
www.audubonsurgerycenter.com
If I had surgery at one of these locations but not on the dates
listed, what should I do?
The employee was not working at either of these locations beyond the
dates listed. So, if you had a procedure on a different date, we do
not believe you are at risk, and you do not need to be tested for
hepatitis C.
Is there a treatment for chronic hepatitis C?
There is a treatment available for hepatitis C, although it does not
work for everyone.
The effectiveness of the treatment varies
depending on the strain of the virus with which you are infected.
Your doctor will be able to discuss treatment options with you based
on your individual test results.
What are the recommendations for people who test positive for
hepatitis C?
Talk to your health care provider about disease management and
possible treatment options, as well as regular health monitoring.
Your health care provider can determine the appropriate next steps
for you.
Should I get tested for hepatitis B virus and HIV?
Both viruses can be transmitted via blood. However, in this
circumstance, we do not believe there was a risk for transmitting
these two viruses.
How do I get my lab test results?
You may obtain the results of your testing for hepatitis C from the health care provider that drew your blood. The provider may have been Rose Medical Center, Audubon Surgery Center or your own personal doctor’s office or clinic.
What do my lab test results mean?
If you tested through Rose Medical Center or Audubon Surgery Center, the facility will call you to discuss your lab results. You also can discuss your lab test results with your own health care provider so he or she can explain in detail what your particular test results mean. In some cases, you may require additional lab tests to determine if you have hepatitis C.
If your lab test results show that you have the virus, your health care provider is the best person to advise you on possible treatment options and the best way to manage the infection. Your health care provider will help you figure out the appropriate next steps. Rose Medical Center and Audubon Surgery Center also can help you identify a medical provider.
In addition to consulting with your health care provider, you may want to access a chart from the Centers for Disease Control and Prevention that will help you interpret your lab test results. You can access the chart here.
If the tests show that I have hepatitis C, how will I know if I got it from the health care worker?
The state health department has a variety of investigative tools that it will use to determine if a person’s infection is related to the health care worker. This includes medical record reviews, interviews and laboratory testing.
If tests show that you have the hepatitis C virus and it is genotype 1 subtype b (called 1b), and if you have enough virus circulating in your body to allow for testing, the Colorado Department of Public Health and Environment (state health department) will forward your blood specimen to the Centers for Disease Control and Prevention (CDC) for further testing called sequencing. The sequencing tests can show how likely it is that the virus you have is the same virus as the one the health care worker has.
No further analysis will be performed by CDC or the state health department on specimens that are found to be genotypes that are not 1b, because they do not match the specimen from the health care worker.
How will the CDC do the sequencing test?
The CDC will perform standard laboratory testing on specimens that are positive for hepatitis C to determine the virus genotype. Specimens that are found to be genotype 1b, the same genotype that the health care worker has, will undergo further sequence testing by CDC. This more extensive sequence testing and analysis is performed to help determine if the hepatitis C virus isolated from specimens obtained from hepatitis C-infected patients is related to the hepatitis C virus isolated from the infected health care worker. The degree of similarity between the viruses from this investigation will be compared and expressed as a percent.
If all the other facts of the case collected by the state health department during the investigation fit with transmission, and if the degree of similarity between the specimens is high (greater than 95 percent), a conclusion can be drawn that there is a transmission link between the health care worker and patient. The results of sequence analysis also can indicate if the viruses are too dissimilar to be related to one another. In some cases, typically due to a lack of enough virus for testing, sequencing cannot be performed and no conclusion regarding similarity can be reached.
As is usual for all public health investigations, all results of laboratory work performed by the CDC will be reported back to the state health department. The health department will release to the public numbers of tests that are linked by sequencing.
The state health department cannot release your test results to anyone without your permission. To obtain your sequencing results from the state health department, you must send a notarized request with your name and date of birth. You can access the request form here:
How long will it take for the state health department to receive the additional test results from the CDC?
At this point, it is difficult to determine how long it will take for the CDC to return results to the state health department, as it is unknown how many specimens will be sent to CDC. It may take several months for the CDC lab to complete genotyping, sequencing and analysis on all specimens that are sent.
Sequencing and analysis of specimens performed by the CDC is for research purposes and to assist the state health department with its public health investigation. These results are not relevant for patient diagnosis and treatment, which is why it is important that clinicians perform their own work-up to determine appropriate care for those who are positive.
Will I need to be retested?
If you had surgery at Rose and have been tested once, you do not need additional testing to determine whether or not you have hepatitis C from any exposure to the infected health care worker.
If you were tested for hepatitis C more than six weeks after your surgery at Audubon, you will not need to be retested. If you were tested sooner than six weeks after your surgery and the test was negative, you will need to be retested after the six-week period has passed. Audubon can help you arrange for that testing.
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