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Hepatitis Bred In Ethnic Communities Poses Threat; Thousands of Guyanese, Russians, Latinos & Ailing In Queens

Hepatitis, a life-threatening disease labeled by medical authorities as a "sleeping giant," of epidemic proportions is sweeping Queens’ vast ethnic communities posing risks to the general population, The Queens Courier has learned.
According to Dr. Stephen Esposito, a renowned liver specialist and researcher, the epidemic of Hepatitis B and C has affected large numbers of recent arrivals to Queens. They reportedly carry the Hepatitis virus because of the breakdown in the health care systems in their homeland.
A City Health Dept. spokesperson, Associate Commissioner Sandra Mullin, admitted to The Queens Courier that the hepatitis epidemic is a "huge and important problem that leaves us frustrated because of the difficulty in obtaining statistics."
She said City health officials are meeting with the U.S. Centers for Disease Control in Atlanta to determine the best means of surveillance of the disease.
"Immigrants from Russia and other trouble-ridden lands who receive blood tests and transfusions from dirty needles often pick up the Hepatitis C infection," said Dr. Esposito, who directs the division of liver disease at New York Hospital Medical Center of Queens.
He said needles used repeatedly in developing countries transmit the disease.
"Hepatitis B is 100 times more contagious than AIDS and 15 times as common," Esposito noted.
He called the borough a "hotbed of Hepatitis," with large numbers of Asian, Russian, Latin American and Middle Eastern immigrants carrying the virus.
Esposito first revealed the details of the hepatitis crisis in the borough on the Queens Courier’s TV program, "Queens On The Air." The interview will air this Friday, April 30 at 8 p.m. on QPTV, channel 34.
Another liver specialist, Dr. P. Patrick Basu, a Rego Park-based Harvard-trained physician, called the hepatitis C situation "an alarming epidemic." He provided the following statistics on estimated cases in Queens ethnic communities:
• Richmond Hill: 10,000 cases, mostly Guyanese.
• Woodside/Corona: 20,000 cases, mostly South American.
• Jamaica: Between 10,000 and 20,000 cases.
• Forest Hills/Rego Park: 10,000 cases, mostly Asiatic Russians.
Dr. Basu called upon the City Health Dept. to screen high-risk cases in the borough and get these patients into treatment programs.
"It only costs $25 per test," he said, "while a liver transplant costs $192,000."
Dr. Basu said symptoms did not give a clear picture of the disease. He noted they are mainly fatigue and malaise, commonly associated with many medical conditions.
"Many of the cases we are seeing today are as a result of individuals who received Vitamin B 12 shots 40 years ago in their homelands from dirty needles and are now suffering from end-stage liver disease.
Dr. Esposito agreed that public health measures are needed in Queens to contain the disease.
"Someone should get into the high schools in Queens and warn adolescents to modify their sexual behavior so they don’t transmit this dangerous disease," Esposito said.
A spokesperson for the City Health Dept. said that such warnings are provided in the health curricula in Queens high schools. (See story on page 54).
Paola Miceli, Borough President Claire Shulman’s health coordinator, said she is looking into the Hepatitis health crisis in the borough.
"We’re awaiting word from the City Health Dept.," she said. "We look to them. Right now I don’t know what the implications are for Queens. We haven’t been brought into it."
Dr. Esposito also warned that Hepatitis B can be transmitted by surgical tools, ear piercing, tattooing or in the dozens of nail salons that women frequent.
"Women should bring their own tools to the nail salon since the sterilization procedures taken by operators don’t kill the Hepatitis B virus," he said. "Tattoo parlors are also a cause for concern since needles are often not adequately sterilized.
Esposito said that while tattoo parlors may use disposable needles some will dip needles in inkwells that are recycled.
According to the New York State Health Dept. it is a violation of the Health Code to share needles or recycle ink.
Meanwhile the U.S. Centers for Disease Control, reported that high rates of Hepatitis B infection continues to occur among children 0-10 of first-generation immigrant mothers (many of whom are found in Queens).
"Special efforts should be made to ensure vaccination of these populations because of their high risk for Hepatitis B infection and death from related chronic liver disease," the federal agency reported.
Federal health officials warn that anyone who has had a blood transfusion before 1992 should be tested for Hepatitis. Prior to that, the officials say, the U.S. blood supply was not adequately screened for impurities that could lead to the disease.
Physicians at Medex, a medical office on Queens Blvd., in Forest Hills, providing health care for the Russian community, see a high percentage of hepatitis
One Russian-American physician, Dr. Igor Zhuravenko, said he screens his patients carefully to determine if they suffer from the disease.
"We see a good deal of it here," he said. "Our patients come from the former Soviet Union in Asia where they experienced very poor medical care."
He explained that needles there are inadequately sterilized and the blood supply is not screened for hepatitis.
Zhuravenko said his patients include those with end-stage liver disease who require transplants.
"It’s a large problem among the Russian population in Queens as it is for individuals who come to the borough from the Far East," he said.
Meanwhile, Dr. Esposito said the two pharmaceutical firms marketing drugs for hepatitis are aware of the large numbers of hepatitis patients in Queens. The companies are Schering-Plough and Amgen.
According to Dr. Clifford Bass, medical director of Plough’s Integrated Therapeutics Division, we are seeing an "epidemic of Hepatitis C in the U.S."
He pointed to Asian groups including Russians who received vaccinations for Hepatitis 10 to 15 years ago with dirty needles who are now suffering symptoms of the disease.
Many of these individuals are among the recent arrivals in Queens.
"This is like a time bomb," he said. "The prediction is for a tripling of the death rate and a six-fold increase in cases requiring liver transplantation."
Dr. Bass warned that Hepatitis patients who drink should not, "because that is a deadly combination."
Schering-Plough is the manufacturer of Rebetron, a treatment for the Hepatitis C. Government health authorities say that Hepatitis C affects one out of every 70 Americans and is more contagious than the HIV virus that causes AIDS.
While an estimated four million Americans carry the microbe, hepatitis C is a "mystery virus" because it has few symptoms, and can hide undetected in the body for years. Medical experts say that half of those infected eventually develop a chronic form of the infection that in time will destroy the liver, either by cirrhosis or cancer.
Two hepatitis experts, Dr. Joseph B. McCormick and Dr. Susan Fisher-Hoch, said in the book, Hepatitis C The Silent Epidemic, "Though the outcome is not as uniformly dire as with HIV infection, anyone who discovers that he or she is infected with the Hepatitis C virus faces an uncertain future with all the fears attendant on the prospect of chronic, painful disease and possibly death."
One Queens specialist, Dr. Terence Brady, associate chairman of the Dept. of Medicine at New York Hospital Queens, said that the Flushing-based hospital is seeing an increasingly sicker ethnic population.
Brady said if financially-troubled Flushing Hospital closes and New York Hospital Queens’ bed census rises there could be a problem in treating hepatitis cases.
"The biggest dilemma we face," he said, "is coordinating care for this group. We need to help them improve their lifestyles and diets."
Brady called the language problem a serious handicap in reaching out to this population.
"We’re fortunate at New York Hospital Queens because many of our employees help us translate," he said.
Last week, a study in The New England Journal of Medicine reported that the incidence of liver cancer in the U.S. almost doubled in the past decade, an increase the journal blamed primarily on hepatitis C.
Dr. Mary Jeanne Kreek, a world-renowned addiction expert, calls Hepatitis C "the emergent and preeminent public health problem of the 21st century, surpassing HIV.
There is widespread disagreement among the medical community about steps needed to control Hepatitis C infections which are reportedly spreading beyond high-risk groups.
One hepatitis specialist, Dr. Douglas Dietrich, who treats large numbers of AIDS patients, recently reported that he is now seeing large numbers of hepatitis C cases – "one of the more virulent opportunistic diseases that target immune-compromised people."
Dietrich, chief of the New York chapter of the scientific-advisory committee of the American Liver Foundation, has increasingly become angered at his colleagues failure to respond to the rising incidence of hepatitis C cases, and especially by their failure to endorse more widespread testing for the virus.
"It’s apparent to me that we have the makings of a crisis here that is in some ways like the AIDS crisis in its early days," he said. Dietrich points out that while hepatitis C progresses to chronic liver disease in up to 50 percent of cases, the majority of people infected with the virus show no symptoms for decades.