Dirty needles at a private clinic have been blamed for an outbreak of hepatitis C among kids in central China, underscoring the challenges of policing healthcare as clinics mushroom to meet growing demand.

State media reported Tuesday that reuse of needles at a private clinic in Henan province's Maqiao township spread hepatitis C to at least 13 people, including many children.

In the 1990s, Henan province was rocked by unsanitary blood plasma-buying schemes and tainted blood transfusions that allowed HIV to gain a foothold. Operators often used dirty needles, and people selling plasma — the liquid in blood — received replenishment from a pooled blood supply.

The Global Times newspaper said that health officials in Henan's neighboring province of Anhui reported that as many as 56 people may have been infected with hepatitis C at the clinic.

The Chinese-language People's Daily quoted Gao Pei, vice director of the Center for Disease Control in Anhui's Guoyang county, as saying an initial investigation found that doctors at the Miaoqian Clinic in Henan reused needles when giving shots to patients.

The clinic in Henan is close to the border with Anhui, and all the victims so far have been from Anhui, it said.

The People's Daily said investigators were surveying 16 local villages to determine whether more people were infected. Patients were being treated at the Guoyang People's Hospital, it said.

The report didn't say whether the clinic has been shut down or whether anyone had been punished or arrested.

A man who answered the phone at the Maqiao Public Security Bureau said he was unaware of the case. Like many Chinese bureaucrats, he declined to give his name.

China is promoting small-scale private hospitals and clinics as part of a health care overhaul that is meant make services available to more people and ease pressure on its badly overcrowded public hospitals.