'Malpractice' Blamed For Outbreak

Substandard procedures in local clinics may have led to an increase in Chinese hepatitis C cases.

hepatitisc-305.jpg Parents show test results confirming their children have hepatitis C, outside a hospital in Hefei, Nov. 28, 2011,

Bad medical practice in local clinics is being blamed for a recent sharp rise in hepatitis C infections in the southern Chinese province of Guangdong, local residents and official media reports said.

"The local clinics don't use disposable needles for the prevention of infection," said a resident of Zijin county, near Heyuan city, where local people estimate around 200 new cases of hepatitis C have appeared in recent months. "In a society with the rule of law, this should be dealt with according to law."

The resident, who declined to be named, said many people don't trust the local health clinics at all. "Those who can afford it mostly go to the big hospitals to get treatment," he said.

Repeated calls to the Guangdong provincial Center for Disease Control and Prevention (CDC), and to the the Zijin county government health monitoring agency went unanswered during office hours on Thursday.

However, Guangdong CDC director Yi Xuefeng was quoted as saying by the official Xinhua news agency that local authorities were now investigating the reported spike in cases.

"These cases were initially identified before 2010, and the incident cannot be deemed as an outbreak of the disease," the agency quoted him as saying.

Previous official media reports have quoted hospital records in Zijin county as showing a steady rise in hepatitis cases in the past two years, however. Xinhua quoted local residents as saying more than 200 cases had been recorded, adding that local officials hadn't confirmed the figure.

Medical transmission likely

Beijing-based public health expert Lu Jun said it was fairly clear that the concentration in cases around Heyuan suggested medical transmission of the virus, which is spread by dirty needles, sexual contact, and sometimes from mother-to-infant.

Hepatitis C has been on the increase globally in recent years, partly because many people carry the viruses for years without knowing that they have it.

Health authorities in the United States reported this week that hepatitis C, which can lead to liver cancer, now kills more Americans than HIV/AIDS.

Figures for 1999-2007 released by the U.S. CDC showed a significant rise in hepatitis C deaths over the period, to 15,106 in 2007.

"It is clear that the work of infection prevention hasn't been carried out very well in that district," said Lu, a director at the Beijing-based health charity Yirenping. "Both hepatitis C and B are transmitted through bodily fluids ... the transmission route is very narrow."

He drew parallels with the spread of HIV during the 1990s in China via blood-selling clinics in poverty-stricken regions, leading to an explosion of cases among rural residents, and also a parallel hepatitis B epidemic.

"In our country, nearly 100 million people were infected with hepatitis B through dirty needles from the 1960s to the 1980s," Lu said. "According to my analysis, this looks like transmission via medical sources."

Sterilization problems

Zeng Jun, a doctor at the Guangzhou No. 1 Hospital, said sterilization was still a problem in some parts of the country.

"We still see situations in China where the needles aren't sterilized, and the needles are used on other patients," Zeng said. "Supervision is still not good enough."

"There are still consequences among the poorest people and people in rural areas," he said. "If they occur, these sorts of problems should be dealt with very seriously."

Lu said public health scandals, which are commonly reported across China, largely continued to happen because the officials found responsible seldom lost their jobs.

"They won't lose their jobs, or go to jail because of such things, or even get a heavy fine," he said. "As a result, some people in the industry don't take their responsibilities very seriously."

He said a lack of clear channels for medical malpractice victims to pursue compensation claims or complaints also hampered attempts to supervise healthcare professionals.

Reported by He Ping for RFA's Mandarin service. Translated and written in English by Luisetta Mudie.

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