Hepatitis

Like thousands of other patients do every year, John Leto walked into a Glen Burnie cardiology clinic last October for a routine cardiac stress test. But what happened over the next two months wasn't so routine: The 79-year-old retired ironworker developed a hepatitis C infection that ultimately took his life on Christmas Day. Leto's death - one of just six hepatitis C-related fatalities officially recorded in Maryland since 1999 - is drawing new attention to an unusual medical mystery under investigation by the Maryland Department of Health and Mental Hygiene.

State and federal health officials are still investigating a suspicious cluster of hepatitis C infections in the Baltimore area and have temporarily shut down a specialized Timonium pharmacy that might be linked to the outbreak. Officials at the Maryland Department of Health and Mental Hygiene would disclose few details yesterday, including the location and number of victims infected with the virus, which kills as many as 10,000 people in the United States each year. "It's still evolving," said Dr. Diane Matuszak, acting deputy secretary for public health services, who is leading the investigation.

Maryland General Hospital's laboratory, under scrutiny for months after workers there sent out hundreds of possibly inaccurate lab test results, has corrected major problems, federal regulators have found, and is again in compliance with conditions for participating in Medicare. Regulators who inspected the hospital as a whole last month found that it, too, met the standards for participation in Medicare, despite some violations: a dirty kitchen floor, failure to keep a current nursing care plan for three of 51 patients sampled and a "very messy, disorganized and dirty" pharmacy that was largely cleaned up by the next day. But overall, the Baltimore hospital considers the compliance findings good news.

BAGHDAD, Iraq - A virulent form of hepatitis that is especially lethal for pregnant women has broken out in two of Iraq's most troubled districts, Iraqi Health Ministry officials said in interviews here this week, and they warned that a collapse of water and sewage systems during the continuing violence in the country is probably at the root of the outbreak. The disease, called hepatitis E, is caused by a virus that is often spread by sewage-contaminated drinking water. The officials said that they had equipment to test only a limited number of people showing symptoms, suggesting that only a fraction of the actual cases has been firmly diagnosed.

The U.S. Department of Health and Human Services' investigative arm has subpoenaed documents relating to laboratory testing at Maryland General Hospital, which is under state investigation for Medicaid fraud. The 243-bed Baltimore hospital confirmed yesterday, after an inquiry by The Sun, that it had received a subpoena from HHS' Office of Inspector General. The subpoena, received May 11, sought information and records related to HIV and hepatitis testing conducted at the hospital from Jan. 1, 2002, through Aug. 30, 2003, the hospital said in a statement.

State health department inspectors will conduct a complete review of operations at the troubled Maryland General Hospital, looking beyond the laboratory problems that have been the recent focus of investigation. Federal officials requested the state take this unusual step after concluding that the hospital has serious deficiencies in three areas, according to an April 5 letter made public yesterday: quality assessment, laboratory services and oversight by the hospital's governing body.

The top administrator in Maryland General Hospital's troubled laboratory has been placed on paid leave and will not return to his job, according to a hospital spokesman. James Stewart's supervision of the laboratory has been strongly criticized by state regulators, who have threatened fines of up to $10,000 a day if the 243-bed city facility doesn't take immediate corrective action. He has been on administrative leave for about two weeks and "is not going to return," spokesman Lee Kennedy disclosed yesterday, adding that he could not provide further details regarding personnel matters.

Officials at Maryland General Hospital said yesterday that they will offer free retesting to any patients who were tested for HIV or hepatitis C at the hospital during a 14-month period ending in August of last year. Lee Kennedy, a spokesman for the hospital, said the offer was made to address concerns about the reliability of tests that were performed on an analyzer known as a Labotech. The equipment is no longer being used, and state and hospital officials have determined that about 460 HIV and hepatitis C test results obtained from the machine never should have been sent out. Though Kennedy said he did not know how many additional patients would be eligible for the free tests, the numbers are likely to be in the thousands.

The fight against HIV and AIDS hinges on two equally important factors: preventing transmission and getting treatment. But the first step is knowing whether you're infected at all. "There are significant consequences of not knowing the truth," said Dr. Peter L. Beilenson, Baltimore health commissioner. "The real concern is if someone was thinking they were negative and actually were positive, they may not be as careful as they should be" when engaging in sexual activity. The human immunodeficiency virus, or HIV, can be transmitted during unprotected sex with an infected person or by sharing drug needles with someone who is infected.

MONACA, Pa. - A bright yellow billboard calls out to passers-by - "Hepatitis Claims?" - and displays a law firm's name and phone number along Route 60, just south of this western Pennsylvania town. A few months ago, the nation's worst outbreak of hepatitis A killed three people and sickened 660 others in the vicinity of this town near Pittsburgh. More than 9,000 frightened people flocked to hospitals for tests and inoculations. When the illness was traced to a Chi-Chi's here, the restaurant voluntarily closed its doors Nov. 2. The source turned out to be tainted green onions from Mexico, not poor health practices at the restaurant.