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VA hospitals should not be exempt from requirement to report infections

A Colorado congressman is on exactly the right track in pushing legislation requiring Veterans Affairs hospitals to report infections to state health departments.

It should have been standard procedure a long time ago. Instead, standard procedure has been to hope that veterans hospitals would be kind enough to inform state health officials of problems. So far, that practice hasn’t worked out so well for those who might be affected.

Take, as did Rep. Mike Coffman, R-Colo., the example of the improper reuse of insulin pens at the Buffalo Veterans Affairs Medical Center. News of how more than 700 patients at the medical center may have been exposed to HIV, hepatitis B or hepatitis C through the reuse of insulin pens that should have been used only once demanded a full accounting.

As it turned out, after testing 476 patients, the medical center said only that it had uncovered the possibility of infections. No details. The medical center is undergoing an epidemiologic analysis.

Buffalo isn’t the only place the VA has been slow to communicate. It did not report to state authorities a Legionnaire’s disease outbreak that claimed five lives at a hospital in Pittsburgh in 2011. That non-reporting was the catalyst for Coffman, chairman of the House Veterans Affairs Subcommittee on Oversight and Investigations, to put forth his legislation.

It is probably a surprise to most that VA facilities aren’t already required to comply with state infectious disease reporting requirements. With those reports, health departments can take steps to mitigate an outbreak. Also, knowing that VA facilities must report infections will help the public determine how good the care is at any VA hospital.

The present system, which encourages VA facilities to take it upon themselves to report infectious diseases to state health departments, is clearly inadequate and a disservice to veterans and the public at large.

Dr. Robert L. Jesse, principal deputy undersecretary for health at the Department of Veterans Affairs, suggested improvements can be made “without new mandates in legislation that raise legal complications, as well as create administrative burdens by requiring compliance with many different state laws.”

But if that were true, there wouldn’t be cases such as the one here in Buffalo or in Pittsburgh.

Infectious diseases by their very name do not contain themselves; they are a threat to public health. The public has a right to know, which is why most hospitals are required to report outbreaks. There is no reason that requirement shouldn’t extend to military hospitals.