Elizabeth Moore (not her real name) isn’t surprised about a new epidemic raging in West Virginia.
She saw it happen in her own family, even before the state lead the nation in per capita hepatitis B and C incidence rates.
Her son got hepatitis B from his wife at the time; both were heroin addicts who used whatever needles they could and then had unprotected sex.
“When you are that addicted, people aren’t making good decisions or using good judgement.”
“It is about the here and now for them – just getting through that hour or day,” she said.
When her son was in jail, his wife turned to prostitution to support her heroin habit. They have since divorced.
“Guys would tell him how they had been with his woman, and at one point he thought she’d probably been with at least 50 other men from what he’d heard,” she said.
“So there is really is probably no way of telling how many of them she infected or if they even know about it,” she said.
Federal and state public health officials have since sounded an alarm about the growing problem and whether or not adequate resources exist to handle it.
Doctors attribute the soaring rates to intravenous drug users who get and pass it on by sharing needles.
A report issued in May by the U.S. Centers for Disease Control and Prevention cited a more than triple increase in hepatitis C rates in four Appalachian states: West Virginia, Kentucky, Virginia and Tennessee.
Between 2006 and 2012, hepatitis C rates in the four states increased by 364 percent, and the infection rates were highest among people under the age of 30, the report states.
It also said the largest cause of the infection was intravenous drug use.
“Taken together, these increases indicate a geographic intersection among opioid abuse, drug injecting and hepatitis C infections in central Appalachia, and underscore the need for integrated health services in substance abuse treatment settings to prevent these infections and to ensure those who are infected receive medical care,” the report reads.
State health officer Dr. Rahul Gupta said there is plenty of alarming evidence – exact numbers – showing how bad the hepatitis situation has become in West Virginia, which also leads the nation in its number of drug overdose deaths.
The state situation and its growing incidence rates are especially dire when compared to national rates, he said.
“We have to understand that we have the highest rates of hepatitis B in the country, and not just high but very high – almost 10 times as high as the national average. It’s a difficult disease to have because it is a lifelong disease that can lead to complications like liver failure. Since it’s also expensive to treat it takes a toll on society and the public health system in general,” he said.
State counties reporting the highest number of new hepatitis B cases last year include:
- Kanawha (71)
- Raleigh (28)
- Cabell (16)
- Berkeley and Boone (15 apiece)
- Putnam (14) and Mercer (12)
West Virginia is second in the nation when it comes to hepatitis C cases, several times higher than the national rate.
There were 63 confirmed hepatitis C cases last year in the state which equals to 3.4 cases per every 100,000 individuals compared to a national rate of just 0.7 cases for the same population.
Not only have county hepatitis C rates shown sharp increases, the growth has also been seen in primarily rural counties and communities that now far exceed the national average.
For example, Gilmer County’s reported cases grew from 10 in 2012 to 107 in 2014 which equals 1230.9 cases per every 100,000 individuals. Preston County shot up from 62 cases to 311 or a rate of 927.8 for the same period.
Cabell County’s cases increased from 238 to 616 (639.5) and Kanawha County grew from 517 to 800 and that equals 414.4 cases per every 100,000 individuals.
There is some good news because that a hepatitis B vaccine is available, and public health officials are concentrating on making sure state residents know about it.
“We are collaborating with a number of agencies, especially where we have high risk populations, to try and raise the immunizations rates where the hepatitis B rates are high,” he said.
Challenges remain, especially when it comes to IV drug users.
“This factor is dramatically impacting the spread of both hepatitis B and C so that communities where drug users share needles are especially vulnerable. So we are also working with federal as well as partners in other states to make sure the public is aware of this epidemic,” he said.
“We want people to know that it is important to get into a needle exchange program so they can get clean needles because that is the best way to reduce this risk among drug users,” he said.
Many people still don’t understand that viral hepatitis is very infectious, or that it has longevity. For example, hepatitis B can survive outside the body for at least one week and hepatitis C can survive on equipment and surfaces for up to three weeks, according to the CDC.
But state efforts are expected to help stem the tide as well as provide care to those already infected.
“West Virginia has collaborated with addiction centers and harm reduction services to provide viral hepatitis prevention training,” the CDC report reads.
Those efforts also include outreach to prisons and other places with high-risk populations, Gupta said.
“But probably the most urgent need is to get a handle on heroin use so that we can reduce the risk of transmission, so this is clearly a very complicated problem,” he said.
Featured image via Shutterstock.