Local Health Officials Worried Over Spike in Hepatitis C Cases

 "The Green Bay area is following a national trend."

Health officials fear a public health concern they predicted a few years ago is now happening.

When heroin use began surging locally, they warned a jump in Hepatitis C cases would follow.

Now, that’s exactly what’s happening.

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How the Heroin Crisis Ushered in a Hepatitis C Epidemic

Meanwhile, high prices and stringent requirements from insurers and Big Pharma are limiting access to effective treatment.

The first thing Amy does after rising from the brink of death is apologize.

“I’m sorry,” she says, scanning the small crowd of first-responders who have formed a semi-circle around her. She rummages through her scalp with fingernails painted lime green. By a hair, she has missed becoming the city’s latest casualty of a heroin overdose.

It’s just past 2:30 p.m. on a broiling Tuesday afternoon, and Amy (whose name has been changed to protect her privacy) is lying in a small courtyard on the side of Wing Fook Funeral Home, a few blocks from Boston Medical Center. Earlier in the day she had purchased a $20 bag of heroin and snuck behind the fence and shrubs of the funeral home to a set of semi-private benches, where she shot up and overdosed. Boston Emergency Medical Services responded to the call in less than four minutes. Amy, who is 20, is the second overdose they have fielded since noon. Already, they’d treated a 28-year-old man who had collapsed on the men’s room floor at the East Boston Public Library. In about 25 minutes, they will respond to their third overdose of the day, a 35-year-old man they’ll find unconscious on the lawn of South Boston’s Moakley Park.

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Urban ERs see high rates of hepatitis C infection

American College of Emergency Physicians

WASHINGTON --An urban emergency department that set up a hepatitis C testing protocol saw high rates of infection among intravenous drug users and Baby Boomers, with three-quarters of those testing positive unaware they were infected. The results of a screening and diagnostic testing program for hepatitis C were reported online Tuesday in Annals of Emergency Medicine ("Results of a Rapid Hepatitis C Virus Screening and Diagnostic Testing Program in an Urban Emergency Department").

"Given skyrocketing rates of injection heroin use around the country, we expect the already high rates of hepatitis C infection to explode," said lead study author Douglas White, MD, of Highland Hospital, Alameda Health System in Oakland, Calif. "Intervention by emergency departments, in the form of screening and referral for treatment, could help slow the spread of this potentially deadly, communicable disease."

Researchers tested 10 percent of emergency department patients for hepatitis C virus (HCV), mostly but not exclusively focusing testing on those considered high-risk, such as intravenous drug users, Baby Boomers and patients with unspecified liver disease. Of patients tested, 10.3 percent tested positive for HCV, with 70 percent of those confirmed as chronically infected. Only 24 percent of patients who tested positive for the virus had prior knowledge of HCV infection.

Hepatitis C virus is the most common chronic blood-borne infection in the U.S., affecting an estimated 3 million people and is a leading cause of end-stage liver disease, liver cancer and liver transplants. It is estimated that HCV prevalence in the United States among people born between 1945 and 1965 (the "Baby Boom") is as high as 4 percent. Baby Boomers account for 75 percent of people living with HCV infection and as many as 1.75 million of them do not know they are infected.

"In addition to the myriad public health functions they already perform, urban emergency departments may play an important role as safety net providers for HCV screening," said Dr. White. "We have a better than even chance of reaching many of the three million people who are infected since they tend to be heavy emergency department users already. It gives us a chance to connect these people to ongoing care at HCV clinics or elsewhere in the health care system."

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Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, the national medical society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information, visit http://www.acep.org.

Press Release Source:  http://www.eurekalert.org/pub_releases/2015-08/acoe-ues080615.php

Hepatitis C numbers up in Maine, Androscoggin County

Hepatitis C numbers are up in Maine, with Androscoggin County seeing some of the highest rates of acute cases in the state.

Experts say there are a variety of reasons for the increase, including a spike in heroin use — the hepatitis C virus is transmitted by blood and shared needles commonly spread it — and a new, dramatically more effective treatment that's made patients more willing to be tested.

"We are seeing people coming out of the woodwork to seek treatment for hepatitis C," Imad Durra, infectious disease specialist with Central Maine Infectious Diseases in Lewiston, said.

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Following Spike in Hepatitis C Cases, Kentucky Considers Expanding Screenings for Virus

Officials at the state and local levels are in discussions about offering hepatitis C testing at all Kentucky county health departments.

Some local offices offered the tests last year as part of a pilot project, when Kentucky began to see a spike in hepatitis C cases related to intravenous drug use. The Centers for Disease Control and Prevention said in May that Kentucky’s rate of hepatitis C is seven times higher than the national average.

Deputy Commissioner Kraig Humbaugh, with the Kentucky Department of Public Health, says increased screening opportunities would be a way for health and addiction experts to reach out to those who need help.

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Tennessee Dept. of Health issues public health advisory on hepatitis C epidemic

"The rate of acute Hepatitis C cases in Tennessee has more than tripled in the last seven years, and the steadily increasing number of cases may only represent “the tip of the iceberg” of the state’s Hepatitis-C epidemic, according to TDH Commissioner John Dreyzehner, MD, MPH."

NASHVILLE (WATE) – The Tennessee Department of Health is issuing a public health advisory urging residents to increase their awareness about hepatitis C, a life-threatening disease spread by direct contact with blood from an infected person.

The Knox County Health Department says it’s important to know all the risk factors. Within the last year there’s been an increase of testing for the virus at the health department. Director Dr. Martha Buchanan says her staff will be looking at that data and determining what can be done.

“The best protection you have is knowledge and knowing what behaviors and what things put you at risk,” said Buchanan.

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Hepatitis C surge in central Ohio may spur needle-exchange program

The boom in heroin use paired with a surge in hepatitis C infections in Franklin County and across Ohio have heightened worries about the spread of other diseases, particularly HIV, and sparked conversations about a local needle exchange.

Hepatitis C, a treatable but sometimes deadly viral disease that attacks the liver, was diagnosed in 719 people in Franklin County five years ago. The number had nearly doubled by last year, to 1,369, according to data from Columbus Public Health. So far this year, the county is on pace to record more than 1,400 cases. In just one year, the number of hepatitis C cases statewide grew from 10,020 in 2013 to 15,887 in 2014.

Some of that most certainly is due to a push for testing at-risk baby boomers that has been fueled by better treatments. But there’s little question among doctors and public-health leaders that needle-sharing by people using heroin and other drugs is playing a role. Last year, 603 of the cases in Franklin County were in people 34 or younger.

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Hepatitis C cases soar with Maine heroin epidemic

Maine is undergoing its worst acute hepatitis C outbreak since it began recording cases in the 1990s. Reported cases of the disease have soared since 2013, corresponding with skyrocketing heroin use, and are more than triple the national average.

The heroin epidemic is causing many undesirable ripple effects in Maine, public health advocates say, including the spread of infectious diseases such as hepatitis C.

Acute cases – a six-month infection where symptoms manifest themselves – more than tripled from 2013 to 2014, from nine to 31, according to the Maine Center for Disease Control and Prevention. At the same time, chronic hepatitis C – long-term infections that can sometimes last a lifetime – increased 25 percent, from 1,142 cases in 2010 to 1,425 in 2014.

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Hepatitis C cases continue to rise in Northeast Tennessee

A recent Centers for Disease Control report shows an increase in Hepatitis C in our region. The report shows an increase in Tennessee, Virginia, West Virginia, and Kentucky.

Health care providers have been discussing the increase for well over a year now to try to limit these numbers. One organization is even working on a pilot program to help educate the community and provide help for those who have tested positive.

"Northeast Tennessee and East Tennessee in general has among the highest rates of Hepatitis C in the country," Northeast Tennessee Regional Medical Director Dr. David Kirschke said.

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Southern Illinois sees shocking rise of Hepatitis C

Cases of Hepatitis C -- a blood borne virus that attacks the liver and is spread via shared drug needles, unsterile tattoos and other means -- are on the rise. It's a "silent epidemic" waiting to strike many unsuspecting Baby Boomers and young adults, health officials warn, because the liver has a long memory. Even if you have forgotten what you did this past weekend, or in the freewheeling 1970s, your liver did not.  

Hoping to stem the tide of premature deaths from liver-related complications, lawmakers narrowly passed a bill in recent days that would require doctors to offer screening tests for patients considered high-risk for Hepatitis C.

It is curable in most cases, but left undetected can lead to cirrhosis of the liver and death.

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Injection Drug Use Fuels Rise In Hepatitis C Cases

May 26, 2015 4:22 PM ET

Kristin Gourlay 

Listen to the Story

 

The rise in injection drug use across the country, especially the eastern U.S., is fueling an outbreak of hepatitis C. Outreach workers are offering clean needles and testing to contain the spread.

Source:  http://www.npr.org/2015/05/26/409804741/injection-drug-use-fuels-rise-in-hepatitis-c-cases

CDC Warns of Rise in Hepatitis C Cases Linked to Injection-Drug Use

Reported Hep C cases in young people more than tripled from 2006 to 2012 in Kentucky, Tennessee, Virginia and West Virginia, CDC study finds 

The Centers for Disease Control and Prevention warned about a sharp increase in hepatitis C infections linked to injection-drug abuse in four Appalachian states, and called for better health services to contain the spread.

Reported cases of acute hepatitis C infection in people ages 30 or under more than tripled from 2006 to 2012 in four states—Kentucky, Tennessee, Virginia and West Virginia—according to a new study published by the CDC Thursday. Among patients for whom associated risk factors were reported, more than 70% reported injection-drug abuse.

During the same period, the number of people under 30 admitted to substance-abuse treatment facilities for opioid drugs grew by 21% in those states. A significant proportion of these people identified injection as their main method of drug use.

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Resurgence of hepatitis C in Mass.

The opioid epidemic that is killing hundreds of intravenous drug users who overdosed this year in the state has resulted in a Hepatitis C epidemic, according to state health officials.

Most of those drug users, they note, are people younger than 30 who probably used contaminated syringes.

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