16 March 2000

A right medical muck up

by Kate Melville

In many countries proactive mass vaccination programmes have long been a key part of many public health campaigns. Generally these programmes work but not always.

In Egypt at least 15% of the population has been infected with hepatitis C and this is probably attributable to a mass vaccination programme targeting Schistosomiasis, a condition caused by a parasite in the blood.

From the 1950s up until the 1980s, hundreds of thousands of Egyptians received a vaccination treatment, called parenteral antischistosomal therapy (PAT). Today, pills rather than vaccinations are used to treat schistosomiasis.

The link between the two events has been uncovered by researchers from the University of Maryland School of Medicine, working in conjunction with the World Health Organization and the Egyptian Ministry of Health and Population. Their startling results were published in this week's issue of UK medical journal The Lancet.

The study concluded that hepatitis C virus happened after contamination of reusable needles and syringes used in the treatment of schistosomiasis.

"They were given the only available form of treatment for a serious disease, but the treatment was administered with reusable injection equipment, as was the standard in those times," says Christina Frank, a doctoral candidate at the University of Maryland School of Medicine and author of the study. "Doctors meant well, but they were unaware of the dangers associated with inadequate sterilization procedures. The treatment campaigns were conducted with the best of intentions, using accepted sterilization techniques of the time. Testing for hepatitis C only became available in the early 1990's, years after PAT injection campaigns had ended."

In what would have to be one of the biggest understatements of the year Thomas Strickland M.D., Ph.D., professor of Epidemiology at the University of Maryland School of Medicine described this epidemic as, "somewhat paradoxical"!