In medicine, when there is an effort to address a problem, often we find more problems.
During the multi-state hepatitis A outbreak that started in 2018, there were 2,561 cases identified in West Virginia. Kanawha County was hit hard by this outbreak, with 809 cases of hepatitis A. This was an unprecedented number of cases for the disease in some of our most vulnerable people.
During this time, the Kanawha-Charleston Health Department worked with other health care partners, including the Kanawha County Emergency Ambulance Authority, West Virginia Health Right, the West Virginia Bureau for Public Health and the University of Charleston School of Pharmacy to increase testing for hepatitis A, B and C, as well as HIV and other STDs.
A concentrated effort in testing and immunizations for hepatitis A helped stop this outbreak. With the additional testing, more cases of hepatitis C also were identified. According to the West Virginia Division of Infectious Disease, 1,080 of the individuals in the hepatitis A outbreak also were infected with hepatitis C. There were 199 people identified as co-infected with hepatitis B.
An estimated 2.4 million people in the United States are living with hepatitis C. Acute hepatitis C occurs within the first six months after someone is exposed to the virus. Chronic hepatitis C can be a lifetime problem, if left untreated. For someone contracting acute hepatitis C, approximately 15-25 percent of those patients will clear the virus from their body without treatment. There is a 75-85 percent chance these patients will develop chronic hepatitis C infection and up to 20 percent will develop cirrhosis over time. There is also a 1-5 percent annual risk of developing hepatocellular carcinoma.
It’s important to note that there are treatments available for those living with hepatitis C, but we need to identify these individuals to connect them to treatment. The availability of treatment has been a challenge at times, especially to those patients living in rural areas who may have limited access to health care.
With the recent discussion surrounding hepatitis C, we need to increase our efforts for even more testing and connecting those patients with the disease to care. Although a majority of new cases are due to intravenous drug use, the Centers for Disease Control and Prevention recommends routine hepatitis C testing for other individuals.
- Everyone born from 1945 through 1965.
- Current or former injection drug users.
- Recipients of blood products before 1987 and recipients of blood transfusions or solid organ transplants prior to July 1992.
- Chronic hemodialysis patients.
- Patients with HIV.
- Children born to hepatitis C infected mothers.
- Health care workers with needle-stick injury from a patient with hepatitis C positive blood.
The U.S. Preventive Services Task Force also recommends hepatitis C testing for people who have a history of incarceration, people who use intranasal drugs and people who get an unregulated tattoo.
Hepatitis C is a blood-borne pathogen. It can be spread by sharing needles, contact with contaminated blood products and sexual contact. People who might be living in close contact with a person known to have hepatitis C, out of an abundance of caution, should also be tested. It is not spread through the air or in food or water. Hepatitis C is not spread by sharing eating utensils, hugging, holding hands, coughing or general contact.
As we have seen an increase in hepatitis C rates in multiple counties within West Virginia, we need to not only continue our collaborative testing efforts but increase them. As a community, we need to come together to provide testing and treatment in a concentrated effort to stop the spread of disease, as well as connect those affected to treatment.
The Kanawha-Charleston Health Department has this testing available Monday through Friday from 8 a.m. to 4 p.m. We are also increasing efforts through our valued partnership with West Virginia Health Right, the CAMC Ryan White Program and Covenant House to reach out into the community.
People can also get tested during regular business hours at Health Right; from 8 a.m. until noon every Tuesday at Covenant House; and from 4:15 to 6:15 p.m. on the third Sunday of each month at Trinity’s Table, in Charleston. We appreciate your support and partnership.