News broke a few weeks ago about a possible drug diversion event in Colorado. The more we here about the details of this incident, the more we understand just why a national registry for healthcare workers is so important. Even with the current registry the state of Colorado has for surgical technologists, we see that we have still fallen short in regard to gaps in the system.
It appears the surgical tech who was caught with a syringe in an operating room where he was not scheduled has lost every previous hospital job due to drug violations. At least one other job he was caught stealing a syringe and in still another he tested positive for fetanyl. It appears 4 states are now involved in an ongoing investigation. Read more
Prior to my 2009 Hep C infection I paid little, if any, attention to issues of safe injection practices, drug diversion or outbreaks. In my ordinary life, I had no concern for such things. In fact, I am not even sure I could adequately define any of those terms prior to the chaos of 2009 and the outbreak in Colorado.
But since, I have kept myself in the know, paying attention to trends, outbreaks and legislation to protect patients. My email inbox and social media accounts are littered with stories, mostly bad, about errors in patient care. I truly hope that some of the initiatives I have become a part of will put a stop to most of these incidents. However, in preparing for every situation in an attempt to prevent these events you will find a tale so far fetched you want to read the facts 2 or 3 times just to insure what you initially thought you heard was correct. Read more
Renewed Call to Action on Worldwide Injection Safety
Steve Langan, director of HONOReform recently attended the World Hepatitis Summit, hosted by the World Hepatitis Alliance. Following is his report.
I am grateful for the opportunity to represent HONOReform and our advocates and stakeholders at the inaugural World Hepatitis Summit earlier this month in Glasgow. I commend the leadership and staff of the World Hepatitis Alliance—Charles Gore, Raquel Peck, Su Wang, just to name a few—who put together a thoughtful and comprehensive meeting.
About 700 of us attended, representing 90 countries. It was a thrilling meeting. I reconnected with old friends and allies and met a lot of people from all over the world who share the desire to prevent and treat viral hepatitis.
According to the WHA, 400 million people are affected with viral hepatitis. Almost a million and a half people throughout the world die every year as a result of being affected by viral hepatitis. It’s the seventh leading killer in the world. Still, it seems that many people remain nonchalant not only about the disease itself but by its most common form of transmission in developing countries—through the medical injection process.
Earlier this year, Evelyn McKnight and I attended the Safe Injection Global Network meeting at the World Health Organization. Evelyn shared her powerful story. The WHO made a commitment to focus on encouraging developing countries—India, Egypt and Uganda, as a starting place—to only use single-use injection devices and to put these one-time-use devices in to play by 2020.
This one fact alone is, to us, a sufficient call to action: Up to 70 percent of the infections of viral hepatitis in India are transmitted through healthcare.
This call to action makes me think of the men and women in the villages west of Delhi. We had the opportunity last year to visit India and meet patients and their family members who were infected with viral hepatitis during healthcare. Watching Evelyn McKnight talk with these patients—mediated by a translator, but the emotions were universal—is one of the most memorable moments of my career.
For them, and for the many other patients throughout the world who go to the doctor and come out with an injection of viral hepatitis, we encourage the WHO and its many partners—governments and industry, in particular—to renew the commitment to injection safety in developing countries.
We have said it before but we will say it again: No person should go in to a medical facility for treatment and leave with an infection of viral hepatitis. Not in 2015. Not with all of the resources and materials that can easily, and affordably, be put in to play.
The World Hepatitis Alliance Summit has ended; countries with different cultures face the same opponent. People around the world are working according to their particular circumstance – some, under a clear strategy, others day by day – but all familiar with the challenges and difficulties of others, because they have lived it and therefore recognized in the other his equal.
For those involved in this problem it is not only a full-time job, it’s a personal matter that is constrained by the pervasive lack of resources and political commitment of many decision makers to prevent prompt and effective medical care. A recurring theme is the voracious appetite for profits of pharmaceutical companies.
But camaraderie is a link between the participants and shows that not all storm clouds darken the sky; there are rays of hope. People who work at government level show their commitment as human beings who seek to help others, their names very rarely recognized in the media but through them their governments have decided to take action:
Brazil is a case closer to us in American continent but Egypt, Georgia, Scotland among others, have made successful negotiations with manufacturers of drugs for hepatitis C that will provide access to an important treatment of their populations affected by the “silent enemy”.
Special mention is that of Egypt. It not only achieved a fair price but also has a clear strategy: to treat its 10 million people infected with hepatitis C by 2025. From October 2014 to August 2015 they gave 130,000 treatments and have been getting the cure for 85%. Next year it aims to provide 350,000 treatments.
Another case is Scotland. They recognized early in this century the serious public health threat from hepatitis and established a strategy to be developed in several phases, which began in 2006 and continues today. They have a strategic vision, which demonstrates the importance of planning ahead with short and medium term goals. They showed to other governments of the world that the time of analysis and planning should have been 10 years ago, not now that the bomb has exploded and urgent action is needed.
The remaining countries continue to do the best they can despite the Olympic sized lack of commitment by their decision makers.
The battle under such circumstances is unmatched, to say it politely. Governments remain entrenched despite seeing such a large segment of its population annihilated under the pretext of not having enough resources.
Talking about the discrimination, stigmatization and loss of jobs that patients and their families face should exert enough pressure on our governments to act promptly to stop the spread of the disease and reduce the number of deaths from this war without quarter.
A good example for taking action is the serious problem of the use and sharing of injected drugs and the importance of an injection safety program.
Thanks to the World Hepatitis Alliance, the Ministry of Health of Scotland, the governments of Brazil, Egypt and Georgia, to the people who work in government, and the pharmaceutical companies that genuinely share our goals.
But especially you, the patient, family member, and friend that advocate to seek a better quality of life for those affected by hepatitis C . And to all the parents, brothers, children, wives, husbands who have died in this unjust war, thank you for your courage and tenacity.
Up to 1.5 million deaths, annually, caused by infections of viral hepatitis
We stand alongside our many colleagues throughout the world, including representatives of the WHO, one of whom, Dr. Stefan Wiktor, refers to hepatitis as the “silent epidemic.” Hepatitis is the seventh leading cause of death throughout the world Many of these cases of hepatitis, especially in developing countries, are caused by unsafe injection practices.
HONOReform is honored to be included in the inaugural World Hepatitis Summit, which will occur early next month in Glasgow. We are grateful to the World Hepatitis Alliance for including us in these meetings. HONOReform continues to seek ways to expand and provide injection safety education and awareness in developing countries. I will report back from these meetings. In the meantime, we encourage you to read about the proposed WHO-led pilot program--in India, Egypt and Uganda–to which we aim to lend the leadership of Evelyn McKnight and HONOReform’s experience, determination and voice.
Hepatitis C and preventive measures by Dr Mudasir Firdosi
We would like to thank Dr. Mudasir Firdosi for helping to highlight Hepatitis C as a truly global issue. This is re-printed from a post which appeared in mid-May.
Kashmir valley is witnessing another disaster in the form of Hepatitis C epidemic. In some villages in Kokernag area, the number of cases is around 40% of the total population. In spite of media pressure, and demand from local population, authorities are still contemplating curbing the further spread of this infection. Similar scenario exists in other districts of the valley like Shopian, Kupwara, and Srinagar.
Hepatitis C is not transmitted by routine personal contact and there needs to be an actual transfer of the virus via blood, blood products and body fluids, from one person to another. From the sociodemographic profile of the rural population, one can easily exclude intravenous drug abuse or sexual contact as the cause of the current epidemic in majority of cases.
Possible Hepatitis, HIV Exposures in Santa Barbara, CA
My heart skipped a few beats last week when I read about the potential outbreak resulting from a lack of safe infection control measures in a doctor’s office in Santa Barbara County. Things had been going fairly smoothly in regard to safe injection practices. In 2014, none of the investigations which took place found any disease transmissions. In fact, we had not had an investigation over the last six months and although we never stop educating and spreading awareness, we were able to breathe a small sigh of relief. Read more
A heartfelt thank you to some very hard working epidemiologists
A huge thank you to the wonderful epidemiologists at both the Colorado Department of Public Health and Environment (CDPHE), Division of Disease Control and at the Centers for Disease Control and Prevention (CDC), Viral Hepatitis Division for their major article published this month in the American Journal of Infection Control. Their article, “Outbreak of hepatitis C virus infection associated with narcotics diversion by an hepatitis C virus-infected surgical technician,” outlines the happenings surrounding the Hepatitis C outbreak in Colorado in 2009. Their in-depth study of this situation brilliantly highlights the need for better health surveillance in identifying such outbreaks and the diversion which causes them.
We are so grateful to Desarae Mueller-Fichepain, whose father’s story was featured last week in the article written by reporter Matthew Hansen. And we are grateful to Mr. Hansen, who we got to know when he joined us to take a tour of one of the four factories operated here in the state by our corporate colleagues BD (Becton, Dickinson and Co.).
These exchanges, advocate to reporter and reporter to readers, are essential ones. Continued education and reeducation on proper injection safety is vital. What happened to Desarae’s dad, Mr. Emil Mueller, should not happen to anyone here in the United States—or, we think, anywhere in the world.
It is our honor to share the article, published in the Thursday, December 11, Omaha World-Herald. We thank Desarae, and all of the HONOReform advocates, for their openness, leadership and support.
Hansen: In massive hepatitis C outbreak in Fremont, the victims’ voices went unheard
Emil had fought off prostate cancer for a decade, battled it in the same steely way that he made it through each shift at Fremont’s Hormel plant. He clocked in at the plant each morning. He picked up his knife. He cleaved the fat off of giant, immovable slabs of ham.
Day after day. Year after year. No excuses. No complaining. That’s how Emil worked. That’s how he lived.
And then, in 2000 or 2001, Emil began to see the new oncologist in town, a doctor by the name of Tahir Ali Javed. He’s a nice guy, he told his daughter, Desarae.
But within months, Emil began to change. The color started to fade from his cheeks. His grit faded, too.
When I was infected with Hepatitis C, my daughter had just turned one. The devastation of such a horrendous diagnosis coupled with the new person who was now in my life was almost stranger than fiction. Now more than five years later, after a wild ride and a journey still in process, I have started to open up to my daughter and talk a bit about the drug diversion which caused my disease.
I know, I know, Lucy is only six and the idea of drug diversion seems a pretty intense subject for a first grader. But every so often she asks me to tell the story and I know which one she means. And as it is a very long story with many twists and turns, I always ask, which part?