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State’s Hepatitis C
cases doubled during
past year

Health officials have begun
a statewide phone and
mail survey

By Helen Altonn
Star-Bulletin

Hepatitis C cases nearly doubled in the past year, as increased screening is detecting the "silent disease," according to health officials.

The state Department of Health has begun a random, statewide telephone and mail survey to try to determine how the viral infection is being spread and to take steps to control it.

Dr. Paul Effler, state epidemiologist, said that the infected population isn't necessarily growing, but that more cases are being picked up by physicians.

Doctors didn't have to report Hepatitis C to the Health Department until 1997 and there wasn't a test for it until recently, he said.

Still, the number of cases identified has been higher than expected -- jumping to nearly 3,000 by the end of 1999 from about 1,700 in 1998, he said.

Hepatitis C causes inflammation of the liver. It is the most common cause of liver failure and liver transplants in the nation, but it can be treated.

Effler said 80 to 85 percent of those infected will develop chronic liver inflammation, and the disease will quietly progress over 20 or more years.

"Up to 20 percent of those infected will develop cirrhosis (liver scarring) and some of these individuals will eventually progress to liver failure or liver cancer."

Dr. Robert Jao, a hepatologist, or liver specialist, said, "We believe there is a large (infected) population out there and the increase in numbers is because of increased screening. "

Jao, who works with the Liver Center at St. Francis Medical Center, said it's hard to assess the true incidence of the disease because not everyone gets screened. "The disease stays silent."

Until stages of cirrhosis, the symptoms are vague, he said, such as fatigue, loss of appetite and dark urine. "All of these things are not very specific. They don't point the doctor to Hepatitis C right away."

Jao said doctors identify the disease when they evaluate patients for other reasons or see these risk factors: Intravenous or injection drug use, especially when a person has shared or used dirty needles; inhalation of drugs and sharing of an inhalation tube with others, and tattoos with a contaminated needle.

Contaminated blood transfusions were a major source of the disease until 1992, when more sophisticated blood testing eliminated that as a cause, the doctors said.

But people who had transfusions before 1992 might have acquired the infection and not know it, Jao said.

About half of the new cases now are due to drug use and occur in young adults, according to the Health Department.

State Health Director Bruce Anderson asked the public to cooperate with the anonymous surveys, which he said "will go a long way toward helping the department implement effective controls for Hepatitis C."

Residents may receive a phone call requesting basic information and permission to mail a questionnaire.

The caller will identify himself or herself as from the DOH and provide a department phone number if residents want to make sure the call is legitimate.