Enhanced Surveillance for Hepatitis C in
Young Adults
Background
The Florida Department of Health (FDOH) is currently conducting enhanced
surveillance of newly reported hepatitis C cases in adults aged 18-30.
Hepatitis C is an inflammatory liver disease caused by the Hepatitis C virus
(HCV). HCV can lead to both acute (short term) and chronic (long term)
infections. It is the most common blood-borne viral infection in United
States. Starting in 2005, Florida has seen an increase in the number of
chronic hepatitis C cases in young adults. While the statewide rate of
chronic hepatitis C has shown an overall decline, during that same time
period there has been an increase in the states incidence rate among young
adults infected with hepatitis C, with rates doubling in the last eight
years (~50 cases per 100,000 to ~100 cases per 100,000). Similar trends have
been seen in other states (see MMWR May 6, 2011
http://www.cdc.gov/mmwr/pdf/wk/mm6017.pdf).
The Bureau of Epidemiology recently received funds from the Centers for
Disease Control and Prevention (CDC) to conduct enhanced surveillance in
this population to identify risk factors that may be contributing to the
increased incidence of hepatitis C in young adults. As part of this project,
FDOH will be contacting individuals in select counties who are between the
ages of 18-30 and were recently reported to FDOH with a hepatitis C
infection. We will be asking those individuals to answer some questions that
are designed to help us determine how and when the person was exposed to HCV.
The CDC estimates that about 3.2 million people in the U.S. are infected
with hepatitis C. About 80% of those infected with HCV will become
chronically infected, meaning the virus will not clear after 6 months. Most
people with a chronic HCV infection do not have symptoms and lead normal
lives. However, in 10-25% of people with chronic HCV the disease will
progress over a period of 10-40 years and may lead to serious liver damage,
cirrhosis (scarring) and cancer of the liver. HCV is the most common
underlying cause of liver transplants in the U.S.
Prevention
Unlike for hepatitis A and B, there is no vaccine for Hepatitis C, but there
are things people can do to prevent it. HCV is transmitted by direct
blood-blood contact. To avoid exposure to HCV, do not share needles or any
other drug paraphernalia (cookers, tourniquets, straws, pipes, etc.).
Personal items such as razors, toothbrushes, nail files, or any other items
that may come in contact with blood should not be shared. Also make sure
that instruments used for tattooing, body piercing and acupuncture are
properly sterilized, and that all cuts and wounds are covered. Although
sexual transmission of HCV appears to be rare, you can reduce the risk by
practicing safe sex and always using condoms.
In the past, this disease has been difficult to manage, but today there are
new treatments available. It is important for people infected with the
hepatitis C virus (HCV) to be seen by doctor. All people with HCV should be
vaccinated against hepatitis A and B, which can be very serious for someone
who is HCV+. The CDC recommends routine testing for HCV for the following:
-
Persons who inject drugs, or ever injected drugs, including those who
injected just once or a few times many years ago
-
Persons who received a blood transfusion or organ transplant before July
1992
-
Persons who received clotting factor concentrates before 1987
-
Persons who were ever on long-term dialysis
-
Children born to HCV+ women
-
Health care, emergency medical and public safety workers after
needlesticks, sharps or mucosal exposure to HCV+ blood
-
Persons with evidence of chronic liver disease
Enhanced Surveillance Project
The Enhanced Surveillance for Hepatitis C in Young Adults project has two
main goals: 1) to collect risk factor information for all newly identified
cases of chronic hepatitis C in participating counties and 2) to collect
information such as symptoms to help determine if the HCV infection which
has been classified as chronic is actually a newly acquired or acute
infection. The risk factor and symptom information will help us determine
why more young adults are becoming infected with HCV and to identify areas
to target for prevention efforts.
The enhanced surveillance will target new cases of hepatitis C infections in
those aged 18-30 that were reported to the state between March 1 and July
31, 2012. Fourteen county health departments are participating in the
project. If you are in the 18-30 age range and recently had a blood test for
Hepatitis C performed, you may be contacted for an interview if you live in
one of the following counties:
|
Alachua |
Clay |
Duval |
Escambia |
|
Hillsborough |
Miami-Dade |
Nassau |
Orange |
|
Osceola |
Palm Beach |
Pinellas |
Sarasota |
|
Seminole |
St.
Lucie |
|
|
If you are contacted, please help us by participating in the 20-30 minute
telephone survey. If we can not reach you by phone, you may receive as survey in the
mail to complete and return to FDOH.
The information you
provide will be very important in helping us figure out how to prevent other
people from getting hepatitis C.
Thank you for your valuable participation!
For
questions regarding this investigation, contact the Bureau of Epidemiology at
(850)245-4401.
