LAS VEGAS -- A type of protein that hepatitis C carries led medical investigators to two potential infection dates in 2007, said officials from the Southern Nevada Health District.

"Those surface proteins are under a lot of pressure from the immune system," said senior epidemiologist Brian Labus. "We know the blood came from the source patient and somehow got to all those patients. So, knowing where it started and where it ended, we can make determination about what happened."

These events pinpointed to July 25, 2007, and Sept. 21, 2007, officials said. On each day, a patient infected with hepatitis C had a procedure done.

According to the investigation, between March 2004 and February 2008, staff at the Endoscopy Center of Southern Nevada reused medical vials and syringes on multiple patients, leading to cross contamination, agents said.

More than 50,000 people were exposed to the blood-borne pathogens during that time, leading to the largest public health notification in U.S. history. All former patients of the center were asked to be tested for hepatitis B, C and HIV.

Labus said that pinpointing the exposure dates will help the SNHD's investigation into the outbreak because it could lead them into how it was spread.

"Once we had those dates, we found all the other patients on those days did testing on those days for people who are positive," he said. "We then matched their viruses to see who the source was and who was infected that day."

While officials said it is possible that other infection sources can be identified, medical officials are still having difficulty investigating the crime.

"We have a problem where we knew somebody had something and didn't do the things that were required by universal precaution," said Board of Heath physician Dr. Joseph Hardy.

A total of nine cases of chronic hepatitis C have been linked to this investigation -- eight from the Endoscopy Center of Southern Nevada and another from its sister facility, the Desert Shadow Endoscopy Center.

More than 80 other cases of hepatitis B, C and HIV have also been linked to the Endoscopy Center of Southern Nevada, officials said.

Health district officials are currently working on a patient registry to help identify additional cases or exposures.

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