"Military recruits encountered the same hazards
as civilians during the 1960s and '70s, and many contracted Hepatitis C Virus.
A 1999 study found an Hepatitis C Virus rate of 6 percent to 8 percent among Vietnam
vets at San Francisco's VA hospital-roughly four times the rate
in the general population. The numbers are no great surprise; VA
patients almost always have more health problems than civilians
(or other veterans). But some infected vets deny having any known
risk factor. "People falsely assume that hepatitis C is due
to poor personal conduct," says Bill Schwartz, a West Point
graduate who served two tours in Vietnam and retired as a lieutenant
colonel before joining Litton Industries as a marketing executive.
Like many infected veterans, Schwartz believes the air guns used
to vaccinate GIs in long queues may have spread droplets of blood
from one person to another. Dr. Lawrence Deyton, the VA's chief
public-health officer, is wary of jumping to such conclusions. "Was
it combat wounds? Medical procedures? Use of the inoculation guns?"
he asks. "We don't have the data yet. We simply don't know."
The hazards of military service should become clearer this summer,
when the VA releases a survey comparing Hepatitis C Virus rates among veterans
of various wars." Hepatitis C: The Insidious Spread of a Killer
Virus
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Document Name & Link to Document
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Description
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2006 VA HEALTH, INCOME AND OTHER BENEFITS |
Many fans of movie musicals can recall Joan Blondell belting out
“Remember My Forgotten Man” against a moving tableau of
World War I doughboys in Busby Berkeley’s film, Golddiggers
of 1933. In one of Hollywood’s rare early forays into
social issues, the song and dance number called for better
treatment of the World War I veterans who’d just been
spurned by President Hoover, the lame-duck GOP Congress and
even future World War II hero General Douglas MacArthur, who
used tanks to disperse thousands of unemployed and disabled
veterans demonstrating peacefully for benefits in Washington
the year before.
But over 70 years later, Blondell’s torch-song lament still
rings true: Most of us aren’t aware of benefits which are
available to all veterans – and especially disabled
veterans -- and they and the benefits due them too often
remain “forgotten.” (For just one example, in 2000 Lawrence
Deyton, MD, the VA’s national coordinator of HIV care,
estimated that only 18,000 of an estimated 85,000 to 130,000
eligible HIV-positive veterans had signed up for the VA
health care to which they’re entitled.) Here’s a brief
survey of income and health coverage programs for veterans
of active duty with general or honorable discharges. |
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BLOODBORNE PATHOGENS EXPOSURE CONTROL PLAN |
Department
of the Army control plan- To prescribe policies,
responsibilities and procedures for implementation of the
Bloodborne Pathogen Exposure Control Plan (BBPECP) to meet the
letter and intent of the OSHA Bloodborne Pathogens Standard
(29 CFR 1910.1030). OSHA has enacted this standard to "reduce
occupational exposure to Hepatitis B Virus (HBV), Human
Immunodeficiency Virus (HIV) and other bloodborne pathogens".
This plan details measures WRAMC and its employees will take
to decrease the risk of transmission of bloodborne pathogens
and provide appropriate treatment and counseling should an
employee be exposed to bloodborne pathogens. |
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Ethical Challenges in the Care of Persons With Hepatitis C
Infection: A Pilot Study to Enhance Informed Consent with
Veterans
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Four
million Americans are currently infected with HCV. The high
response rate to combined antiviral therapy for HCV suggests
that this treatment is both cost-effective and clinically
beneficial. The patients with the strongest clinical
indications for treatment with interferon and ribavirin are
most often those who possess addictive and psychiatric
disorders that are potential barriers to successful
treatment. The ability of these patients to provide informed
consent for treatment is thus essential if they are to take
advantage of scientific and institutional progress in the
area of HCV therapy. Our early work with an HCV informed
consent assessment process designed to identify clinician-,
patient-, disease-, and treatment-specific factors
influencing informed consent can provide the basis for
educational and therapeutic interventions to maximize
patients’ decisional capacity to enter into and complete
combined HCV therapy. |
Pdf 82 kb |
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Ethical Challenges in the Care of Persons With Hepatitis C
Infection: A Pilot Study to Enhance Informed Consent With
Veterans |
Four
million Americans are currently infected with HCV. The high
response rate to combined antiviral therapy for HCV suggests
that this treatment is both cost-effective and clinically
beneficial. The patients with the strongest clinical
indications for treatment with interferon and ribavirin are
most often those who possess addictive and psychiatric
disorders that are potential barriers to successful
treatment. The ability of these patients to provide informed
consent for treatment is thus essential if they are to take
advantage of scientific and institutional progress in the
area of HCV therapy. Our early work with an HCV informed
consent assessment process designed to identify clinician-,
patient-, disease-, and treatment-specific factors
influencing informed consent can provide the basis for
educational and therapeutic interventions to maximize
patients’ decisional capacity to enter into and complete
combined HCV therapy. |
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Hepatitis C in Vietnam Era Veterans |
Hepatitis
C is a major problem in United States military veterans. In
several studies of Veteran’s Affairs (VA) Medical Center
patients, we find that 8-9% are positive for hepatitis C
antibodies. Some VA Medical Centers had 10-20% of patients
with hepatitis C antibodies.1,2 The highest rate of
hepatitis C is found in the Vietnam era veterans. Several
studies have been initiated to better understand the high
frequency of hepatitis C in veterans of the Vietnam
conflict. Areas of research include the demographic
characteristics, risk factors for infection and the
potential role of military service in the acquisition of
hepatitis C1. Underlying this research is the question of
what is unique about Vietnam or Vietnam-era veterans to help
explain a high prevalence of hepatitis C which was not
observed in World War II or Korean era veterans. |
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Hepatitis
C
Screening in the VA
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"Hepatitis C is a serious national health crisis
with an estimated four million Americans infected, many of
whom are veterans and many of whom are not even aware they
are at-risk," said Chairman Shays. "But after two years,
the laudable promise of the VA initiative to screen and treat
Hepatitis C Virus-infected veterans remains unfulfilled. The decentralized
VA health system seems incapable of carrying out the Hepatitis C Virus program
aggressively or consistently."
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Hepatitis C treatment guidelines for Vets |
Treatment
guidelines from the Veterans Administration |
13 kb pdf |
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Hepatitis
C Origin Points to Possible Military Link
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Hepatitis, not Hepatitis C, was a serious medical
condition for military personnel during the Vietnam War.
Thousands of servicemen contracted the disease and the Pentagon
was determined to do something about it to resolve a drain
on combat readiness.
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Hepatitis C Virus Infection Among U.S. Military Personnel:
An Assessment Of Risks and Screening Strategies |
For
recruits enlisting in 1997, the prevalence of infection was
just 0.1% (1 per 1000 recruits). The risk of infection for
Reservists was similar to active duty personnel after
adjusting for age. The prevalence of infection in active
duty personnel who had been on duty since the Vietnam era
was actually lower (1%) than the prevalence (3%) among other
military personnel of similar age (greater than 40 years
old). Individuals retiring from the military in 1997 were on
average 45 years old and had a prevalence of infection of
1.7%. |
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INCARCERATED VETERANS ARE ELIGIBLE FOR VA
MEDICAL CARE AT VA HOSPITALS AND CLINICS |
It is
important to note that the VA doesn’t permit armed guards at
its medical facilities. While there is no bar to unarmed
escorts accompanying persons in correctional custody
into VA waiting areas, escorts may well have to negotiate
physicians’ consents to accompany inmates into examination
and treatment rooms. And there would be even more problems
with 24-hour-a-day escorts for hospitalized inmates. |
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Jet injectors can
regularly transmit relevant volumes of blood
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LHI in their reflective practitioner role receive
many requests for advice on the prevention and control of
infection and outbreaks. These cover infection control
in hospitals and other, wider aspects of healthcare.
One example of this was recently generated in the Infection
Control Unit and concerns the transmission of blood
borne infectious agents by jet injectors. These injectors
use a high-pressure focussed jet of fluid to provide
a needleless mechanism for penetrating skin.
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Obtaining VA benefits
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From the Code
of Federal Regulation |
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Presumption
of service-connection for certain veterans with Hepatitis C,
and for other purposes. |
To amend
title 38, United States Code, to establish a presumption of
service-connection for certain veterans with Hepatitis C, and
for other purposes Be it enacted by the Senate and House
of Representatives of the United States of America in Congress
assembled,. SECTION 1. PRESUMPTION OF SERVICE-CONNECTION
FOR CERTAIN VETERANS WITH Hepatitis C, |
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Presumptive Service Connection in VBA |
Power Point
Presentation |
86 kb |
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Prevalence
of Hepatitis C and Coinfection with HIV Among United States
Veterans in the New York Metropolitan Area |
US veterans
who are receiving medical care at VA medical centers in the New
York City metropolitan area have a much higher rate of chronic
hepatitis C than the general population…coinfection with HIV is
very common in patients with confirmed HCV infection, and these
patients should routinely be offered HIV testing |
206 kb pdf |
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VA HEPATITIS C PROGRAM |
The
Centers of Excellence have also developed risk factor and
counseling recommendations for all VHAs, as well as
treatment guidelines for the care of veterans with
hepatitis C. These treatment guidelines will be updated
periodically, and as there is a greater experience of
clinical care, they can be broadened to be more inclusive.
Management guidelines, such as the need of vaccination
against hepatitis A and B, have also been distributed
throughout the VHA system. |
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Veterans and
Hepatitis C
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When the Balanced-Budget Act passed in 1997,
many feared it would have a severely detrimental effect on
VA health care. The fear most frequently expressed
was that since veterans discretionary funds were frozen by
the BBA, VA health care resources would eventually be stretched
too thin.
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We offer a monthly newsletter dealing with
the various issues surrounding infectious diseases. To
find out more click
HERE. |
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Veterans
Comprehensive Hepatitis C Health Care Act (Introduced in
Senate) |
To amend
title 38, United States Code, to establish a comprehensive
program for testing and treatment of veterans for the
Hepatitis C virus. |
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Veterans’ Health Care:
Observations on VA’s Assessment of Hepatitis C Budgeting and
Funding |
GAO report on
identified differences in both Hepatitis C activities that
were included in VA’s original fiscal year 2000 budget:
screening and antiviral drug therapy. VA budgeted $195
million for these activities, but only spent $50 million, a
$145 million difference…We believe that management decisions
could have contributed to lower than expected screening and
treatment expenditures, in addition to the factors VA cited. |
104 kb pdf |
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Viral Hepatitis among US Navy and Marine Corps-1987
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Six hundred and twenty-nine cases of viral hepatitis
(A, B, and NonA-NonB) were reported among a total of 768,832
United States Navy and Marine Corps personnel during 1984
and 1985 via a passive surveillance system. Cumulative incidence
for all three hepatitis types was higher than those reported
for the general population at the same time.
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Groups representing the
nation's military veterans say they are "howling
mad" that the Republican leadership in the House of
Representatives backpedaled on a promise to approve $1.8
billion for healthcare funding and caused substantial delays
in service personnel receiving medical treatment.
"We
have a situation. The demand (for treatment) has grown
enormously and the funding has not kept up for it, and as a
result you have the rules being changed and people not being
able to get into the system,"
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