County working to lower hepatitis risk

CLARKSBURG — Though Harrison County has some of the highest number of hepatitis cases in the state, a viral outbreak similar to the one recently reported in the Beckley area would be rare.

In that outbreak, 12 hepatitis cases have been linked to a private heart clinic. The hepatitis B and C viruses apparently were spread through medications injected during cardiac stress tests.

Nationwide, however, only 44 outbreaks of viral hepatitis in relation to health care services have occurred between 2008 and 2014, the Centers for Disease Control and Prevention has reported.

“It’s possible anywhere, anytime when you’re dealing with blood exposure,” said Margaret Howe-White, Harrison-Clarksburg Health Department nursing director.

In a health clinic, staff is responsible for changing tubing and changing needles that are at risk for contamination, particularly when using multimode vials, Howe-White said.

“It’s not real common, but it does happen, and that’s why staff is trained on proper protocol of handling those things,” she said.

Although the risk of a clinic-related viral hepatitis outbreak is low, Harrison County continues to see high numbers of hepatitis cases.

In 2013, the Harrison-Clarksburg Health Department saw 100 cases of hepatitis C, followed by 118 cases in 2014, Howe-White said.

“From January to December 2015, we investigated 25 cases of hepatitis B, 149 cases of hepatitis C and 1 case of hepatitis A,” she said.

“Those are the ones we know about, so that’s only the tip of the iceberg,” Howe-White added.

Harrison-Clarksburg Health Department administrator Chad Bundy credited a drop in hepatitis B cases in 2015 to a program the department joined two years ago.

“We were contacted by the state, being one of eight counties in the state that were incorporated in pilot hepatitis B programming,” Bundy said.

The program, which was funded through a state grant, allowed the department to expand its community outreach.

“We did an outreach program where we went out and sought out high-risk groups that could potentially be infected with hepatitis B,” Bundy said. “We gave several vaccines throughout that two-year process.”

Bundy added that the department still has the vaccine and can administer it as needed, even though the pilot program has ended.

Though the three types of hepatitis are contracted in different ways, they share similar symptoms such as fever, fatigues, abdominal pain, jaundice or yellowing of the eyes, Howe-White said.

“Some people can have an infection and just think that it’s the flu,” she said. “That’s one of the big problems.”

Hepatitis C is on the rise, not only in Harrison County but nationwide. The CDC reported an estimated 29,718 cases of acute hepatitis C virus infections in 2013 and an estimated 3.5 million chronic hepatitis C virus infections.

According to the CDC, intravenous drug use is the most common way hepatitis C is spread in the United States.

“We’re in the top numbers for hepatitis C in this area, and that has to do with the high number of injecting drug users,” Howe-White said.

Hepatitis C is transmitted primarily through contacting blood from a person infected with the disease.

It is the most dangerous of the hepatitis viruses.

“It can become a lifelong problem, and it can be transmitted to other people,” Howe-White said. “Up to 70 percent of those people will go on to create chronic liver disease.”

During the last Board of Health meeting, a decision was made for the health department to move forward with a harm reduction program in an effort to decrease disease transmission.

“It basically allows for the health department, and the county in general, to hopefully be able to push down communicable disease that stems from heavy, heavy drug use in our county,” Bundy said during the meeting.

He said the county’s lack of such a program is creating more chances that diseases will spread.

“Even though we don’t have an exchange program, they’re exchanging the needles themselves throughout the community — whether through a rest area, a restaurant or those types of things,” Bundy said. “It’s very concerning.”

With similar programs implemented in Cabell and Monongalia counties, Howe-White is optimistic that a harm reduction program would be successful in Harrison County.

“When you’re looking at the harm reduction that’s been put in place, it has not increased the incidence of drug users, and it decreases the incidents of infection,” she said.

Though commonly referred to as a “needle exchange” or “syringe exchange,” Howe-White said harm reduction programs are about more than just providing needles.

“What you’re also looking at is referral resources and helping people get treatment services or counseling,” Howe-White said. “It’s not just all about a needle exchange. There’s a whole lot more to harm reduction than just that.”