Massive Hep C
Epidemic In Egypt Caused
By Injection Campaign
PARIS (AFP) - A massive campaign in Egypt to eradicate a blood parasite went disastrously wrong, causing an epidemic of hepatitis C that infects up to a fifth of the country's population, according to research released on Friday.
US and Egyptian epidemiologists, in a report to be published in Saturday's edition of the British medical weekly The Lancet, said the hepatitis was transmitted across the Egyptian population through unsterilised needles and reused syringes that were used to combat a blood fluke.
It is the world's biggest case of blood-borne viruses being spread by a medical campaign, they said.
The anti-fluke campaign, called parenteral antischistosomal therapy (PAT), was conducted across Egypt from the 1950s to the 1980s.
It entailed giving between 12 and 16 intravenous injections of an antimony salt, tartar emetic, to each patient over a short period, the study said.
However, the injections were often administered by reusable syringes and needles that were either not sterilised properly or used for multiple doses for a number of people in one sitting.
The injection campaign ended when a cheap, oral medication became available -- but by that time, there had been an "epidemic spread" of hepatitis C, and many people had probably become contaminated with hepatitis B as well, the researchers said.
Between 15 and 20 percent of Egypt's population of 63.3 million have antibodies to hepatitis C, meaning that they have been infected by the virus but may not necessarily have the symptoms of the illness, they said.
Hepatitis C is a virus that makes the liver swell, causing it to malfunction.
Symptoms are jaundice, nausea and chronic fatigue. In its advanced state, it can lead to liver cancer. The only effective treatment are anti-viral drugs, which are expensive and have side effects.
The virus is spread by contact with an infected person's blood, such as sharing needles used for intravenous injection, tattooing or body piercing. It can also be transmitted by having sex with an infected person, although this is rare.
The study spoke sympathetically about the causes for the epidemic, saying the PAT campaign was driven by an awareness of the huge size of the blood-fluke problem and an enthusiasm by the Egyptian medical community to stamp it out.
Ironically, in countries that were indifferent to the parasite problem, there was no significant transmission of hepatitis C.
"The sheer size of the antischistosomiasis effort in Egypt, combined with the characteristics of PAT, provided an effect mechanism for establishment of (hepatitis C) in the Egyptian population," the study said.
"This is the world's largest (medically-caused) transmission of blood-borne pathogens known to date, which probably led to a massive increase in the reservoir for (hepatitis C and hepatitis B) in the general population."


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