Dozens of patients of an Oklahoma dental clinic shuttered for unsanitary conditions have tested positive for hepatitis, Tulsa health officials said Thursday. The clinic of oral surgeon W. Scott Harrington was shut down in March after an investigation.

So far 57 current and former patients who may have been treated with dirty equipment have tested positive for hepatitis C and three tested positive for hepatitis B, the Tulsa Health Department said in a statement. 

“We understand these first reported test results may be of concern,” said THD Director Dr. Bruce Dart. “Thorough investigations are routinely conducted upon notification of a positive report for these infections. This response will be handled in the same manner, as disease investigation is a core public health service and staff are well trained to conduct this type of response.”

Positive results for HIV have also been reported, but Oklahoma law prohibits public reporting of cases fewer than three.

On March 28, investigators from the Oklahoma State Department of Health and Tulsa Health Department urged as many as 7,000 patients of the Tulsa dental clinic to be screened for hepatitis B, hepatitis C and HIV, after a patient of Harrington's had tested positive for hepatitis C. The patient had no other risk factors for the infectious disease. Inspectors for the Oklahoma Dentistry Board called Harrington "a menace to the public health" after finding dirty instruments and improper sterilization procedures, the Associated Press reported.

Current and former patients who tested positive are being personally contacted and counseled, state health officials said. Patients with negative results will receive letters in the mail.

It's possible at least some of the positive infections are not related to exposure to procedures at the dental practice, health officials said.

“This is a complex investigation,” State Epidemiologist Dr. Kristy Bradley said in a statement. “The next phase will include more in-depth interviews of persons who test positive to determine the likelihood that their exposure is associated with their dental surgical procedure at the Harrington practice. We will certainly continue to keep the public informed as we learn more.”

According to the statement, an estimated 4,944 persons are living with HIV/AIDS in Oklahoma and as many as 68,000 Oklahomans may be infected with hepatitis C.

So far, the state lab has screened 3,235 current and former patients for the bloodborne viruses. It's unknown how many patients have been tested through private doctors.

Harrington voluntarily gave up his license and is reportedly cooperating with the investigation. 

NBC's KJRH contributed to this report. For more visit KJRH

OLEAN, N.Y. -- A second western New York hospital is notifying patients that they may have been exposed to HIV, hepatitis B or hepatitis C through the improper sharing of insulin pens, hospital officials said Thursday.

Olean General Hospital was mailing letters to 1,915 patients who received insulin at the hospital from November 2009 through last week, advising them to call to arrange for blood testing. The risk of infection is very low, hospital officials said, but they wanted patients to be aware of the possibility.

Hospital officials said the action follows an internal review conducted after the Veterans Affairs hospital in Buffalo discovered more than 700 patients may have been exposed to blood-borne pathogens over a two-year period when multi-use pens intended for use by a single patient may have been used on more than one person.

"Interviews with nursing staff indicated that the practice of using one patient's insulin pen for other patients may have occurred on some patients," said Timothy Finan, president and chief executive of Upper Allegheny Health System, the parent company of the Olean hospital.

Olean General had not identified any specific patients who may have received an injection from another patient's pen and knew of no cases of infection, Finan said in a news release.

"Regardless, to the extent there may be a chance, however remote, that any patient was provided insulin from an insulin pen other than their own, Olean General Hospital has decided to be proactive and aggressive with respect to notification of our patients," the release said.

As was the case in Buffalo, needles were changed with each use of the insulin pens, the Olean hospital said. The risk of infection remained, however, because stored insulin in the pen cartridge could have become contaminated by a back flow of blood with each use.

"We are very aware that while the risk of infection from insulin pen re-use is extremely small, cross-contamination from an insulin pen is possible," Finan said.

Federal health agencies have been warning against sharing insulin pens for several years. The Food and Drug Administration issued an alert in March 2009 after learning that more than 2,000 patients may have been exposed at a Texas hospital between 2007 and 2009.

A clinical alert from the Centers for Disease Control and Prevention last year came amid continued reports of the practice.

The pens have been removed from use at Olean General. They were never used at a second hospital in the Upper Allegheny Health System, Bradford Regional Medical Center in Pennsylvania, Finan said.

Revelations of the issue at the VA hospital led the Department of Veterans Affairs Inspector General to initiate a review of the Buffalo hospital.

Commentary

Giving clean needles to IV drug addicts saves lives – and money. That’s why the federal government should be spending your tax dollars to keep drug users -– and the people who have sex with them -- from getting AIDS and hepatitis.

But Republicans in Congress have decided that despite a veritable mountain of scientific evidence showing that needle-exchange work, they are not going to pay for this sort of program any more.

They just yanked it out of the end-of-year spending package.

Shouldn’t public health policy be guided by the best evidence we have about what reduces the dangers and costs of AIDS and hepatitis?

Studies done over more than 15 years across the U.S. and in Australia, Hungary, Holland, Ukraine, Canada, Portugal, Switzerland, Brazil, Belgium and Germany show that there is no doubt that needle- exchange programs lower infection rates for HIV and hepatitis C.

Less infection not only means fewer deaths, but lower costs associated with caring for infected people. 

So what reason might Congressional Republicans or anyone else have for deciding to ignore the evidence and let people die, increase the infection rate and add to the cost of your medical insurance?

It’s not about the money. These programs are inexpensive for such a highly effective public health measure.

The reason is a belief that simply won’t go away: Giving out free clean needles sends the message that injecting drugs is OK.  That belief just happens to be completely unsupported by any evidence at all. 

Whatever leads people to decide to ruin their lives by becoming injection drug users, it is certainly not the chance to get free needles. 

Policy involves more than scientific evidence when it comes to touchy subjects like drug addiction. However, morality cannot ignore the facts. 

If needle-exchange programs do reduce risk, suffering, deaths and costs and it is beyond dispute that they do then it is bad ethics to insist on a moral message that is utterly disconnected from the harsh realities of drug abuse.

Art Caplan, Ph.D., is the director for the Center for Bioethics at the University of Pennsylvania.  Follow him on Twitter @ArthurCaplan.