Hepatitis C cases on rise in northeast Indiana, Allen County proposes needle-exchange program

FORT WAYNE, Ind. (October 6, 2015) — Officials in northeastern Indiana’s Allen County have taken a first step toward creating a needle exchange to combat the county’s growing hepatitis C cases.

The Fort Wayne-Allen County Board of Health unanimously approved a resolution Monday calling for a needle-exchange program to slow the spread of the disease among intravenous drug users.

Allen County has had about 270 new hepatitis C cases during the first nine months of 2015. That’s more than in any of the past three years.

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Hepatitis C cases prompt public health emergency in Fayette County

FAYETTE COUNTY -State Health Commissioner Jerome Adams, M.D., M.P.H., has declared a public health emergency for Fayette County, allowing the county health department to establish a syringe exchange program as part of a broader effort to reduce the spread of Hepatitis C.

"Fayette County is battling a Hepatitis C epidemic tied to intravenous drug use," said Dr. Adams. "County officials have submitted a comprehensive, multi-pronged plan to combat this epidemic, and a syringe exchange is one part of this effort to help reduce the spread of this devastating disease."

Senate Enrolled Act 461 made syringe exchange programs legal in Indiana for the first time, under certain circumstances. The law lays out a set of procedural and substantive requirements that local communities must meet in order for an emergency declaration to be considered by the state health commissioner. 

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Rules restricting access to hepatitis C drugs leave patients waiting

INDIANAPOLIS (WISH) — Indiana’s HIV outbreak has generated more concern about another potentially deadly infection – hepatitis C.

But an I-Team 8 investigation has found Indiana’s poorest patients are being denied access to hepatitis C drugs that could potentially cure them.

State Medicaid programs have restricted access to the drugs like Sovaldi, Harvoni and Viekira. Instead of distributing the medications to all those infected, states have set up restrictions that require patients to have certain symptoms – including a fatty liver or liver scarring – before they can get treatment.

It’s not just Indiana – 31 other states require patients to show signs of liver scarring and have a specialty doctor prescribe the medication, according to a June article in the Annals of Internal Medicine.

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Rural docs want looser rules for Hepatitis C treatment

INDIANAPOLIS – The only doctor at the center of an HIV outbreak in rural Indiana cannot prescribe the latest treatments for patients also infected with the deadly Hepatitis C virus.

Dr. William Cooke, a family practitioner in Scott County, is treating dozens of people with HIV, the AIDS-causing virus that exploded in numbers among intravenous drug users earlier this year.

But state Medicaid rules forbid him from prescribing new treatments to those same patients with Hepatitis C, the blood-borne disease that causes inflammation in the liver and now claims more lives than HIV in the United States.

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Madison County plans 4 sites for needle-exchange program - SFGate

ANDERSON, Ind. (AP) — Health officials are working to open four needle-exchange sites in a central Indiana county after being granted state approval for the program because of disease being spread among intravenous drug users.

The Madison County Health Department wants to have the sites open by late July or early August — two in Anderson and one each in Alexandria and Elwood.

People using the program will have access to other services at each site, such as substance abuse treatment programs and assistance in obtaining food and housing, county public health coordinator Stephanie Grimes told the Herald Bulletin

Madison County plans 4 sites for needle-exchange program - SFGate

Indiana drafting county profiles of HIV, hepatitis C rates

Effort aims to help officials detect outbreaks, determine eligibility for needle exchange programs.

State health officials are creating profiles of HIV and hepatitis C rates for all 92 Indiana counties to help local officials detect outbreaks of either disease and determine whether they can seek help under a new needle-exchange law, a top state disease expert said Wednesday.

State epidemiologist Pam Pontones told members of the Indiana State Department of Health's executive board that the agency hopes to quickly complete work on those profiles, which also will include intravenous drug use rates for each county.

Having that data will help county health officials determine whether they're facing an outbreak of either virus and — if it's tied to IV drug use — whether they can request state approval for a needle-exchange program to try to contain that outbreak, she said.

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Entering Leg 2 of syringe exchange triathlon

With law enacted, implementation adheres to prescribed steps

Indiana is about to legalize syringe exchange. This herculean bipartisan effort, led by Rep. Ed Clere, R-New Albany, enacted evidence-based public health policy in a state with a long-starved public health system.

As triathlons go, the syringe exchange legislative process was a tough first leg that will be followed by a second leg of policy implementation and a final leg of impact evaluation. We are now at T1 – that transition between Legs 1 and 2. And Leg 2 will be challenging.

Syringe exchange is part of a comprehensive public health effort to reduce HIV and hepatitis C among drug-injecting populations. Programs “exchange” sterile for used syringes, and link participants to screening and treatment for Hepatitis C and HIV, as well as substance abuse treatment. Studies over the past 30 years have demonstrated their effectiveness at reducing hepatitis C and HIV.

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Indiana lawmakers OK needle exchange programs for communities with HIV, hepatitis C outbreaks

INDIANAPOLIS — Lawmakers looking to prevent a repeat of an HIV outbreak that has rocked a southern Indiana county sent Republican Gov. Mike Pence a measure Wednesday that would allow communities to implement needle-exchange programs if they can prove they're in the midst of an epidemic tied to intravenous drug use.

Pence, who opposes needle exchanges as part of anti-drug policy, said in a statement Wednesday that he looks forward to signing the legislation into law.

He said his office worked with lawmakers to develop "a legal framework" that would give state health officials the resources and flexibility they need to handle health emergencies.

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Jackson County, IN: ‘There is a significant increase in hepatitis C’

As a result of increased HIV testing in southeastern Indiana due to the large outbreak of the viral disease linked to injectable drug use, health officials in Jackson County say there is a significant increase in hepatitis C being reported in the county.  In fact, more than 50 cases of the disease are currently being investigated, approximately 10 times the number of cases reported in a month.

The Seymour Tribune reports: The increase is being attributed to the ongoing HIV outbreak in southeast Indiana, centered in nearby Scott County. That health emergency has caused many people to seek free HIV testing which has led to more Hepatitis C being diagnosed too, said Lin Montgomery, public health coordinator with the Jackson County Health Department.

On Thursday, Indiana Governor Mike Pence declared a public health disaster emergency for Scott County.

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Editorial | Needle exchanges

The alarming epidemic of HIV in Southern Indiana tied to intravenous drug abuse underscores the wisdom of Kentucky lawmakers who included an option for sterile needle exchanges in the comprehensive heroin bill they passed this session.

In Indiana, the surge of HIV cases among 80 people linked to tiny Scott County — population 24,000 — has attracted national headlines and caused Gov. Mike Pence, who has opposed needle exchanges, to reverse course.

Kentucky’s heroin bill was signed into law Wednesday by Gov. Steve Beshear and could result in many saved lives if communities take advantage of the option to offer needle exchanges through local health departments.

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