|
1948 Inoculation Hepatitis Study |
Experience has shown that it is
very difficult to achieve a
fully reliable sterilization of
blood guns. Washing with ether,
alcohol, or other disinfectants
is not sufficient."
|
|
1970 Jetgun Warning & Vaccines |
Though smallpox vaccination by
jet injection is accepted in the
U.S.A." it is rarely carried out
in Britain, partly because of
problems associated with the
dilution of vaccine LYMPH to
volumes...used by jet injectors,
and partly because LYMPH is NOT
necessarily bacteriologically
sterile...regarded as unsuitable
for intradermal inoculation."
Lymph is the same thing as blood
plasma....and plasma contains a
protein called ALBUMIN. So if
plasma is not sterile then
neither is albumiin.
|
|
1977 |
SInce late 1974 and early 1975,
several cases of viral hepatitis
were reported in Italy among
subjects who had received
subcutaneous injections of a
drug containing human
immunoglobulins
|
|
1977 Warning |
Furthermore, the efficacy of the
ISG, manufactured in 1944,
against apparent type non-A,
non-B hepatitis suggests that
this overlooked disease has
existed from at least that time.
|
|
1978 ISG- 90% had acute HCV |
14 batches of anti-D immune
globulin contaminated with
hepatitis C virus... Within 6
months after anti-D
administration, 10% of these
women had no evidence of disease
and 90% had acute hepatitis C
|
|
1982 Plasma derivatives & viral
hep |
low-risk irrespective of the
plasma from which they are
manufactured because they are
heated at 60 degrees C for 10
hours (Albumin, Plasma Protein
Fraction) or because they
contain protective antibodies
(Immune Globulin).
|
|
1986 ISG Formula- 3 Generations |
More than half of the commercial
intramuscular immune globulin
lots, including specific immune
globulin. All immune globulin
products examined were reactive
for anti-HCVproducts, were HCV
RNA positive. All immune
globulin products examined were
reactive for anti-HCV.
|
|
1987 DoD Follow-up |
Serologic Follow-up of 1942
Epidemic of Post-Vaccination
Hepatitis in the U.S. Army-
outbreak was linked to specific
lots of yellow-fever vaccine
stabilized with human serum
|
|
1992-1996 Contamination |
Contaminated Immunoglobulin
Research
|
|
1994 Detection HCV RNA in immune
globulins |
More than half of the commercial
intramuscular immune globulin
lots, including specific immune
globulin. All immune globulin
products examined were reactive
for anti-HCVproducts, were HCV
RNA positive. All immune
globulin products examined were
reactive for anti-HCV.
|
|
1995 |
FDA Guide to Inspections of
Blood Banks-Cohn-Oncley method
relies on precipitation of
plasma proteins
|
|
1996 Cardiac Surgeon Risk |
Transmission of Hepatitis C
Virus by a Cardiac
Surgeon...evidence that a
cardiac surgeon with chronic
hepatitis C may have transmitted
HCV to five of his patients
during open-heart surgery.
|
|
1996 Cardiac Surgeon Transmisson |
Hepatitis C may be transmitted
during surgery- An infected
cardiac surgeon transmitted the
virus to five patients during
open heart surgery.
|
|
1996 CDC Jetgun Advisory
Committee |
Faulty Design...Various routes
of transmission ...documented,
including ...blood products, use
of jet gun injectors with a
design fault that allowed blood
to remain inside the equipment,
re-use of contaminated needles
and syringes, and indirect
transfer from contaminated
environmental surfaces in
haemodialysis units....
|
|
1998 manufacture of human
albumin |
Chromatographic removal and heat
inactivation of hepatitis during
the manufacture of human
albumin- purpose to examine
efficacy... manufacturing
process
|
|
1998-Jetgun Contamination |
This study demonstrated that
needleless injectors become
contaminated during in vitro use
and direct contact with
contaminated surfaces and that
needleless injectors carry over
the contamination to subsequent
sites of release.
|
|
1999 |
Safety and availability of
immunoglobulin replacement
therapy in relation to
potentially transmissable
agents- Cohn–Oncley
fractionation is not sufficient
to remove lipid-coated viruses,
additional antiviral
inactivation steps are required.
|
|
1999 Hepatitis C Survives
|
Hepatitis C NOT Killed by
Commercial Sterilants and
Disinfectants
|
|
1999 Risk of cross-patient
infection use of a needleless
injector device. |
Postejection
reverse flow drew contaminants
into the device, and increased
with ejection volume. |
|
2000 Origins of HCV Epidemic |
"Why does the world's medical
community continue to ignore
these figures...stop the
practice of allowing multi-use
syringes... world over.
mandatory in all mass
vaccination
programs...contribute
significantly to the scourge of
disease..."
|
|
2001 Jetguns Transmit Infection |
Jet Injectors Capable of
Transmitting Blood-Borne
Pathogens-Jet injectors may be
ideal for mass immunization
programs but not until design
refinements eliminate their
capacity to transmit blood-borne
infections....
|
|
2003 Global Burden Italy |
Poorly cleaned glass syringes
used to administer the polio
vaccine in the 1950s and 60s
could have spread the hepatitis
C virus
|
|
2003 NIH Guidelines |
Nosocomial transmission of
bloodborne viruses from infected
health care workers to
patients...some occupations ...
higher risk ... rate of HCV in
oral surgeons
|
|
2003 Risk of EMG Needles |
“Platinum single fiber
electrodes ... including the use
of disposable NCS electrodes, ..
with patients.. with agents
...Hepatitis C virus,
Creutzfeldt-Jakob disease, and
human immunodeficiency virus”.
|
|
2003 Risk of EMG Needles |
disposable NCS
electrodes...patients with ...
Hepatitis C virus,
Creutzfeldt-Jakob disease, and
human immunodeficiency virus”
|
|
2004 CDC Risk Factors |
Position-Any percutaneous
exposure has the potential for
transferring infectious blood
and potentially transmitting
bloodborne pathogens (e.g., HBV,
HCV, or HIV); however, no data
exist
|
|
2004 The Hepatitis Report
|
Natural History, Clinical
Manifestations, and Prognostic
Indicators of Disease
Progression and Survival of
Hepatitis C Virus (HCV)
Infection
|
|
2004 Transfusions- Fatal
Bacterial Infections |
Health-care providers should be
aware of the new standard and
the need for bacterial testing
of platelets to improve
transfusion safety.
|
|
2005 Needleless Connectors
Relationship |
Needleless Connectors and
Bacteremia: Is There a
Relationship? ...integral
components of an infusion
system...healthcare worker
safety ...as part of the
continuing development of
infusion technology
|
|
2008 CDC- Jetguns (PCNIF) Fail
Safety Test |
The study ended early because
the PCNFI failed to prevent
contamination in the first batch
tested (8.2% failure rate)..
|
|
2008 HCV via contaminated
Surfaces |
Nosocomial" transmission in
healthcare settings is the
second most common route of
hepatitis C virus (HCV)
transmission, after shared use
of needles and other injection
equipment.
|
|
2008 Multi-Risk Transmission
Factors |
Frequency distribution of
hepatitis C virus genotypes in
different geographical regions
of Pakistan and their possible
routes of transmission-
Infectious Diseases 2008,
8:69...More than 70% of the
cases were acquired in hospitals
through reuse of
needles/syringes and major/minor
surgery...
|
|
2008 The hazards of blood
transfusion in historical
perspective |
Current technologies require the
addition of either psoralens or
riboflavin to blood, followed by
exposure to UV light. These
methods are being applied to
platelets in Europe and will
comp
|
|
2010 CDC Report- Mulitple
Exposures |
HCV quasispecies sequences from
the patients were nearly
identical (96.9%–100%) to those
from source patients with
chronic viral hepatitis. All
affected patients in both
clinics received
|
|
2010 HCV screening strategies |
HCV testing was performed in
3803. Of these, 11.5% were
positive, prevalence of HCV
infection of 7.7%, 5 times
higher than the estimated...40%
of HCV-positive persons were
unaware of their status.
|
|
AASLD Hepatitis C not an STD |
Study-HCV disease proves not to be
an STD... The disease transmits by
blood to blood transmission. Science
has proved again, this virus does
not transmit unless blood by both
people is exchanged.
|
|
Ambulatory Care Stetting Risks |
Ambulatory Care Setting-
'prevalence 3-7 times higher
than 1.6% reported by CDC'..
expanded to include birth cohort |
|
Clinical management of drug–drug
interactions |
his overview illustrates that
drug–drug interactions are an
important and potentially
frequent problem when using DAAs
in clinical practice. It also
shows, however, that many of the
interactions are manageable by
either dose adjustments or
selecting a safe alternative,
but only if one has sufficient
knowledge and expertise to deal
with these pharmacokinetic
issues.
|
|
Dental treatmen was commonest
conventional risk factor
|
Dental treatment: 278
(32.55%)...Non-conventional
transmission of hepatitis C: a
true possibility ignored... show
very high risk for HCV
transmission by dental
procedures.
|
|
Dr. David Ross, |
VA Director of the National
Hepatitis C Program, reply to
Dr. Cecil
|
|
Dried Hepatitis C Blood Exposure |
The Hepatitis C virus
transmitted for 63 days after
the virus dried and the contents
of syringes and surfaces were
analyzed
|
|
Federal response to Veterans
with Hepatitis C |
"You've got a demon on your
hands," he said. "You'd better
find out where that's coming
from if you can."
|
|
HCV & Depression Meta-Analysis |
One in 4 chronic hepatitis C
patients who start interferon
and ribavirin treatment will
develop an induced major
depressive episode.
|
|
HCV Detected in Dental Surgeries |
Our data indicate that there is
extensive contamination by HCV
of dental surgeries after
treatment of anti-HCV patients
and that if sterilisation and
disinfection are inadequate
there is the possible risk of
transmission to susceptible
individuals
|
|
HCV Disease
Dental Transmission Risk
|
Dental
procedures constitute a risk for
HCV infection for the patient |
|
HCV Disease Dermatological side
effects |
Dermatological adverse events (AEs) are an existing concern during hepatitis C virus (HCV) infection and peginterferon/ribavirin treatment. HCV infection leads to dermatological and muco-cutaneous manifestations including small-vessel vasculitis as part of the mixed cryoglobulinemic syndrome.
|
|
HCV High Comorbidity Burden
|
Chronic hepatitis C (HCV)
disease can be complicated with
comorbid conditions that may
impact treatment eligibility and
outcomes
|
|
Hearing loss related to
treatment |
Sudden
hearing loss
associated
with
interferon.
|
|
Hepatitis C Risk Factors Now
Included Age 45 and older |
..found evidence that screening
recommendations should be
expanded to include the high
prevalence birth cohort
|
|
Hepatitis C Treatment Options |
Study explains available and
future drug treatments for
hepatitis c |
|
High Comorbidity Burden of the
U.S. Hepatitis C Virus-Infected
Population |
The researchers concluded that this U.S. medically insured HCV population is highly comorbid. Effective strategies to manage these comorbidities
are necessary to allow wider
access to HCV treatment and
reduce the future burden of HCV
disease and its manifestations.
|
|
Increasing Prevalence of HCC and
Cirrhosis in Patients with
Chronic Hepatitis C Virus
Infection |
Our analysis highlights that the
prevalence of cirrhosis has
reached very high proportions
among veterans with HCV
infection. Given low anti-viral
treatment rates for HCV, we
believe that the burden of
cirrhosis will continue to grow
as the HCV cohort ages unless
effective treatment can be
provided to HCV patients in a
timely manner. In light of the
increasing burden of cirrhosis
and HCC in patients with HCV,
clinicians and healthcare system
may need to develop strategies
|
|
Insulin Restance Roll in
Treatment Resistance |
IR Effects Treatment Outcome
|
|
Jet injection History and
Applications |
|
|
Jetgun sterilization before use
is unnecessary |
This 1948 study by Robert
Hingson stated the advantages of
the Hypospray injector were, “2)
the mechanical protection and
preparation of the metapules, so
that sterilization of the
instrument before use is
unnecessary,” and "4) in the
field of pediatrics and military
immunizations, the use of this
instrument would save time of
multiple sterilizations of
equipment.” page 72
|
|
Liver Injury & Common Antibotics
Warning |
|
|
Sen Sanders Tells VA Use
Emergency Power Override Hep C
Drug Patents |
Veterans told to wait until the
liver is completely diseased
before qualifying for the new
"miracle" drugs... Read More
|
|
Tattoo RiskFactor |
...those who had a tattoo had a
6.5-fold higher risk of testing
positive for hepatitis C...
|
|
Testing for HCV after exposure |
Approximately 20%...have
symptoms... before the
seroconversioN...average
time...is approximately 50 days,
although it can be as long as
nine months
|
|
Thermal stability and
inactivation of hepatitis C |
The results provide quantitative
evidence for the potential use
of a variety of approaches for
inactivating HCV. The ability of
HCVcc to survive ambient
temperatures warrants
precautions in handling and
disposing of objects and
materials that may have been
contaminated with HCV.
|
|
VA HCV Prevalence VS Therapy
|
The prevalence of hepatitis C
virus (HCV) infection among VA
patients is 3x higher than in
the general population. Recent
VA data indicate that only about
14% of all HCV-infected VA
patients have ever received
antiviral therapy.
|
|
Vaccine- Department of Defense
(DoD) immunization program-
|
Full Report 1997 jet injector
nozzles were frequently
contaminated with blood, yet
sterilization practices were
frequently inadequate or not
followed... |
|
Interferon: A Historical
Perspective |
Unfortunately, the prolonged
peginterferon therapy necessary to
control chronic HCV or HBV
infections was often associated with
serious side effects such as
fatigue, fever, and myalgias,
symptoms of many acute virus
infections, possibly because such
effects are due to the induction of
IFNs by the infecting agents.
|
|
Prevalence of Hepatitis C |
...resulted in a policy of
immune globulin use for all
deployed soldiers. By 1970,
rates were one-half to one-third
of the earlier rates...
Hepatitis B immune globulin is
listed as a Red Cross Risk
Factor for transmission of
Hepatitis C. |
