- Associated Press - Wednesday, April 2, 2014

MINOT, N.D. (AP) - Family members of Minot residents who were part of one of the largest hepatitis C outbreaks in the country in recent memory are still searching for answers.

Forty-four people were infected last year with the virus that causes chronic liver disease and even death. All of the people had been at the ManorCare Health Services nursing home in Minot. Though no one died in the outbreak, it accounted for one-fourth of all hepatitis C infections in the country since 2008, according to the federal Centers for Disease Control and Prevention.

The state Health Department’s preliminary report on the outbreak said neither the state nor the CDC could pinpoint how the patients were infected, though officials said analysis suggested the infection might have been associated with foot care, nail care services or blood services.

“It’s a very big mystery,” Health Department epidemiologist Sarah Weninger told KXMC-TV (https://bit.ly/1ec0qIp ).

Jan Laudenschlager, whose father was infected, said the lack of information on the cause is frustrating.

“We’d just like to know how he got it,” she said. “And the rest of these people, how they contracted it, too.

“To not come up with a cause, or even the original person who had hepatitis C, is very frustrating for us,” Laudenschlager said.

Casmiar Nwaigwe, head of infectious disease at Trinity Hospital in Minot, said it would be “a travesty” if the mystery isn’t solved.

“How can somebody spend six days in a nursing home and come out with hepatitis C? It just shouldn’t happen,” he said.

Some hepatitis C cases are tied to needles used for illegal drugs or tattoos, but the median age of the victims in the Minot outbreak is 84. Some outbreaks also have been tied to medical workers who inject themselves with a drug and then re-use the needle on a patient.

“We did test (ManorCare) employees - we tested about 100 - and there were no positive employees or no employees that became cases as part of this investigation,” Weninger said.

The state Bureau of Criminal Investigation is looking into the outbreak but won’t comment on the investigation because it is ongoing.

The Health Department’s final report is expected this summer. Health officials say about one-third of all hepatitis C investigations fail to find an exact cause.

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Information from: KXMC-TV, https://www.kxnet.com

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