An outbreak of hepatitis B among patients at a weight-loss clinic in Long Beach has been tentatively blamed by health officials on the use of a "jet gun" that is used on a daily basis at the clinic to inject patients with prescribed vitamins and medication.
Since April, at least 23 clinic patients, most of them women, have contracted the debilitating liver infection that is passed through contact with body fluids, such as blood and saliva, and is usually associated with intravenous drug abusers and people who require frequent blood transfusions.
Most cases have been mild, health officials said.
Possibly a First
"It's a fascinating outbreak," said Dr. Jeff Canter, an epidemiologist for the federal Centers for Disease Control. "It's possibly the first associated with the jet gun."
The Long Beach clinic, at 3736 Atlantic Ave., is one of 27 Lindora Medical Clinics in Los Angeles, Orange, San Bernardino and Riverside counties that routinely use the device.
Although no cases of hepatitis have been reported at any of the other clinics, the use of jet guns has been discontinued at all locations upon the recommendation of health officials, who determined that the gun may have been the common source of the outbreak.
A final determination of the cause of the outbreak awaits test results by the Centers for Disease Control. The inoculator gun and blood samples are being studied, Canter said.
Dr. Marshall Stamper, founder and owner of the Lindora weight-loss clinics, said "there is no way in the world that anyone could have gotten it (hepatitis) in our (Long Beach) office." He conceded, however, that "on the other hand, the number (23 patients) is high enough that you have to be suspicious.
"Because the injection gun is suspect, I removed them from our offices immediately, as a precaution."
The guns, which use pressure instead of a needle to inject medication into the skin, have been used without problems at the Lindora clinics for about 12 years, he added.
Stamper said the injection gun is widely used by public health departments and the military.
Dr. Rugmini Shah, director of the Long Beach Health Department, said, however, that it is most commonly used to inoculate large numbers of people during epidemics. It is not recommended for use in providing daily medication, as is done at the Lindora clinics, she said.
Health officials said they are continuing to test current and former patients of the Long Beach clinic for the disease which, because of an incubation period of up to six months, could still surface as late as December.
Hepatitis B is the most serious form of three known viral forms of hepatitis. The others are hepatitis A, usually contracted through consumption of contaminated food or water, and hepatitis non-A, non-B, which was recently discovered and about which less is known.
Although there is no known drug to treat hepatitis B, the body's natural immune system usually halts the infection, Canter said. In a few cases, however, the disease may advance to serious liver malfunction and ultimately liver failure and death.
Common symptoms include lack of appetite, nausea, vomiting and, in more advanced cases, jaundice, Shah said.