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RENO, Nev. - U.S. health officials say a hepatitis C outbreak affecting more than 80 people and exposing tens of thousands more was caused by workers reusing syringes at a Las Vegas clinic.

The Centers for Disease Control and Prevention report bolsters earlier conclusions by state and county officials. Nevada health officials contacted the CDC on Jan. 2 after two people treated at the now-closed clinic were diagnosed with acute hepatitis C.

Officials have linked 84 cases of the potentially deadly liver disease to the clinic and have notified 50,000 patients that they may be at risk.

Another case was linked to a sister clinic.

About 400 former patients of the centre tested positive.

Officials have determined the other patients could have contracted the virus through other means.

Hepatitis C results in the swelling of the liver and can cause stomach pain, fatigue and jaundice. It may eventually result in liver failure. Even when no symptoms occur, the virus can slowly damage the liver.

The CDC investigators said in a report to the Nevada State Health Division that the practice of reusing syringes with the sedative propofol "was observed" at the Endoscopy Center of Southern Nevada.

"Interviews suggested it was a common practice," the report said.

"This was considered the most likely mode of transmission."

The Endoscopy Center and several other clinics were headed by doctors Dipak Desai and Eladio Carrera, whose Nevada medical licences have been suspended pending state Board of Medical Examiners hearings.

Las Vegas police have seized medical records from the clinics, and the FBI, the state attorney general and the Clark County district attorney are involved in a criminal investigation. The owners of the clinics have surrendered business licences and paid $500,000 in fines.

Former patients at the Endoscopy Center are being tested for hepatitis strains C, B, and HIV, the virus that causes AIDS. No cases of hepatitis strain B or HIV have been linked to the outbreak.

Since 1999, the CDC counts 14 hepatitis outbreaks in the United States linked to bad injection practices.

The largest outbreak occurred in Fremont, Neb., where 99 cancer patients were infected at an oncology centre from 2001 to 2002. At least one died.

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On the Net:

CDC report: http://health.nv.gov/

Centers for Disease Control and Prevention: http://www.cdc.gov/