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At least seven patients of an oncodispensary in Kamchatka Krai, who may be infected with hepatitis B and C at the regional dispensary, have been tested for the virus on their own and at their own expense, Izvestia has found out. They never received an invitation for the tests, for which 11 million rubles were allocated after the confirmed outbreak of the disease. On January 18, a hotline was launched in the region to advise on virus infections, but citizens complain that after contacting it, they do not promptly return phone calls and are not sent for examination. On January 25, Governor Vladimir Solodov said that the bulk of the contact patients - those who went through the CT and MRI rooms of the oncodispensary - had been examined. About how the investigation is going on and how the system of identification of victims is organized, - in the material "Izvestia".

How to take tests for hepatitis

Patients of the oncodispensary in the Kamchatka region after the outbreak of hepatitis in the medical institution are forced to take their own tests for the disease, found out "Izvestia". In mid-January, the regional Ministry of Health reported 36 cases of infection with acute forms of viral hepatitis B and C among patients of the regional oncologic dispensary. All of them underwent computer and magnetic resonance imaging with contrast in the office of the regional oncologic dispensary. Later in the report of the authorities a new number of infected - 49.

In large medical institutions of the region additional rooms for taking tests were organized to avoid queues, as Oleg Melnikov, then Deputy Minister of Health in Kamchatka Krai, reported on January 22. Now he is the interim head of the department, on January 25, the governor dismissed Minister Alexander Gashkov.

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Photo: Izvestia/Eduard Kornienko

Nina, a patient of the oncodispensary, told Izvestia that she had undergone CT scans with contrast three times over the past year, the last one in September, but after contacting the hotline a few days ago, she had not yet been called for an appointment.

- After the information about the hepatitis outbreak in the oncodispensary appeared, I called the hotline. They recorded my details and told me to expect a call. The next day I was told that I was not on the list of those who had to undergo a mandatory examination. They also advised me to contact the Ministry of Health for clarification. I underwent the examination on my own, at my own expense, but not everyone has such an opportunity," she said.

Elena, the daughter of another patient of the oncodispensary, also said that no one called her mother, although she underwent MRI with contrast twice a year.

- Mom called the hotline, and they wrote down her data: when she did the study, what exactly she did. And they said she'd get a call. There is still no call," Elena said. - The local Ministry of Health explained to my mom that she had done some other contrast and that is why she was not on the list.

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Photo: Izvestia/Pavel Volkov

Another patient, who asked not to be named, also said that the hotline recorded her data, but never called her for an appointment.

-After that I went and donated blood myself," she added.

Four other people described a similar situation, and they have also already undergone examinations at their own expense.

"Izvestia" sent a request to the Department of Rospotrebnadzor in Kamchatka Krai with a request to explain the hotline procedure and the mechanism of processing appeals from those wishing to undergo hepatitis tests. The editorial board also sent a request to Rospotrebnadzor with a request to name the current number of people infected with hepatitis and tested for the virus as of January 28. A request was also sent to the government of Kamchatka Krai to clarify the timeframe for completing the examination of all those who could potentially be infected with hepatitis.

The bulk of contact patients have already been tested for hepatitis, said Kamchatka Governor Vladimir Solodov on January 25 at a meeting on the issue of infection of patients in the oncology clinic. On that day he specified that tests for viral hepatitis were taken from 2.6 thousand people who are in the risk group.

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Photo: Izvestia/Mitriy Korotayev

However, according to the decision of the Petropavlovsk-Kamchatka City Court, which on December 27 suspended for a month the work of the CT office, through which the contact patients passed, there may be significantly more people in the risk group. The court took into account information from an interim act on conducting an epidemiological investigation into the causes of infectious diseases "presumably related to CT scans with contrast."

"CT and MRI procedures with contrast are performed daily by 20-25 people, including up to three people at the expense of VHI and personal funds, the rest are patients of the dispensary," the court ruling said. - According to the submitted data, CT with contrast was performed in 2023 on 4261 people, in 2024 - on 5010 people, in total - on 9271 people".

It also states that in addition to 36 people with acute hepatitis, another 13 patients were found to have a chronic form of the disease. That is, the figure of 49 people was known at the end of 2024.

Consequences of infection

Khayet Khalilov, a patient of the Kamchatka oncology clinic, told Izvestia that he has been suffering from oncology for several years and the diagnosis of hepatitis B sounded like a verdict to him.

- I was diagnosed with cancer in 2022. Since then, I've had a CT scan or MRI every year. I had these procedures every three months. And then in December 2024, I went to the oncologist, I was supposed to get chemotherapy, but it was denied because my liver was destroyed," he said. - I went to get tested for hepatitis and HIV. I was confirmed to have hepatitis B. Because of this, I have not received chemotherapy since December. I started having pain, really bad pain, hell, because the tumor is growing. It's starting to press on my intestines, I'm almost obstructed. I can't eat, I vomit a lot.

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Photo: Izvestia/Eduard Kornienko

Khayet Khalilov noted that he felt much better while undergoing chemotherapy, although it was bad for the first two weeks after it.

- For me every minute, every hour, every day of my life is happiness. I could eat normally, leave the house, but now for a month and a half I have severe pains every 10-15 minutes, my blood pressure jumps up and down, " he said.

He also complained that despite the severity of his condition and his disability of the first group, he has to stand in line at the polyclinic.

- Recently I had a painful syndrome after an ultrasound. I walked about 15 meters away from the office after the procedure and fainted. It was good that the doctors there reacted quickly and brought me to my senses," Khayet Khalilov said. - When my wife brought me home and we went up to the fifth floor, I also fainted three times.

Another woman told Izvestia that her husband has two types of cancer. According to her, he has been suffering from it for more than six years and it is extremely dangerous for him to be infected with hepatitis.

- We took the news of oncology very hard, infection with hepatitis after a CT scan is a blow. For cancer patients, having such a co-morbidity can be critical," she emphasized. - My husband has one foot in the grave.

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Photo: TASS/Artem Geodakyan

The woman expressed hope that those responsible for infecting patients will be sentenced harshly, because people with cancer take the accompanying hepatitis extremely hard.

- They have even less chance of recovery than if they were fighting cancer alone," she said.

Themost common reason for refusing chemotherapy to cancer patients is liver destruction, hepatologist Alexey Bueverov confirmed to Izvestia.

He also noted that chemotherapy administered to cancer patients reduces immunity, which leads to an increased risk of infection with various infectious diseases, not only hepatitis.

But, the expert emphasized, although both diseases are dangerous for a person, hepatitis in a healthy person is easier to treat, and such patients have a better chance of recovery.

- And if a person with cancer, even in a neglected stage, is diagnosed with hepatitis, it may lead to death, - Alexey Bueverov noted.

Details of the investigation

The probable source of infection - patients, a possible factor of infection, which caused the main intra-hospital epidemic chain of spread of hemocontact viruses - multi-dose vials of saline solution used to assess the patency of the intravenous catheter before and after the introduction of contrast agent, said the court decision to suspend the CT office.

"As alternative factors of nosocomial transmission of hemocontact viruses, the possibility of transmission through the hands of personnel, contaminated disposable injection equipment when it is used repeatedly was noted," the ruling said.

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Photo: Izvestia/Anna Selina

At the same time, the reasons for the infection are to be investigated at the federal level - in Rospotrebnadzor's units, a source close to the investigation told Izvestia. According to him, given the large number of infected patients, it may take up to a year to identify the original source of the virus.

For now, the authorities are reporting on preliminary results.

- According to the results of internal inspection and audit, which was conducted by leading experts in epidemiology and infectious diseases, the preliminary conclusions are as follows: the oncological dispensary found a number of violations related to sterilization, use of consumables and procedures for CT scanning - the website of the Kamchatka region government quotes Vladimir Solodov. - Experts are still investigating the medical component in detail, but it is already clear that the violations are serious, and it can be argued that they led to the spread of infection.

Alexander Zabusov, an expert of the law firm LuckyLegal, told Izvestia that according to administrative protocols, 4 thousand needles for contrast agent injection were purchased for the oncodispensary in 2024, but they were actually used about 9 thousand times. The lawyer examined the hospital's documentation, as he is providing legal advice to one of the victims.

- The needles are intended for single use, but the amount of research conducted suggests that one needle was used for different patients during procedures, " he said.

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Photo: TASS/Mikhail Tereshchenko

In recent months, Vladimir Solodov added, the problems of providing medicines have also been vividly manifested, and a shortage of staff has been revealed. This information was confirmed to "Izvestia" by local residents.

- There is a staffing famine in the region, there are no subspecialists, as doctors have low salaries. We also have constant problems with medicines," emphasized one of the interlocutors.

"Izvestia" sent a request to Rospotrebnadzor with a request to tell more about the revealed violations and planned measures within the framework of the investigation.

But according to the court documentation, among the violations of sanitary rules and hygienic standards identified so far in the office for disinfection were used means that contained aldehydes (glutaric aldehyde is considered a poison).

In addition, in immunodeficient persons (cancer patients), as well as in the early period of acute hepatitis C (up to 12 weeks after infection), full diagnosis of hepatitis, i.e. two mandatory tests, was not carried out - there was only one.

Also, confirmation of diagnoses of viral hepatitis C and viral hepatitis B was carried out within a period exceeding 14 calendar days. This did not allow to ensure the timeliness of prophylactic, anti-epidemic and treatment measures for at least six patients.

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Photo: Izvestia/Eduard Kornienko

In addition, the facility developed 13 standards of operating procedures (SOPs), including for MRI, CT, but the SOPs do not correspond to the actual procedures of the radiology department: there are no SOPs on preparation for work with the injector, on overalls and personal protective equipment, on hand hygiene and antisepsis, on treatment of surfaces after each patient. There was also no specification of SOPs by positions (doctor, laboratory technician, nurse), thus the microbiological monitoring protocol was not implemented.

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