Pubdate: Fri, 09 Jul 1999 Source: Standard-Times (MA) Copyright: 1999 The Standard-Times Contact: http://www.s-t.com/ Author: Nina Catelli Vincent, Fairhaven HEPATITIS C AN INSIDIOUS MENACE FAIRHAVEN Thank you for Polly Saltonstall's article on hepatitis C (Sunday, June 17). Not enough information is available to the general public about this deadly disease. Unfortunately, you only told half the story. Intravenous drug users are not the only ones effected. As with HIV (and maybe more so) the hepatitis C virus (HCV) does not discriminate. Here are some figures from the C. Everett Koop Institute at Dartmouth web site: "Blood transfusions currently seem to account for only approximately 5-10 percent of all cases of hepatitis C." Since the early 1990s all blood and blood products are now tested for HCV. Anyone receiving blood or blood products prior to 1992 may be at risk. "Household contact with another household member that has hepatitis C has also been strongly implicated, and this, in combination with heterosexual exposure, is believed to be responsible for approximately 13 percent of all infections. The incidence of household-member transmission cases has more than doubled since 1990. Maternal-infant transmission has also been documented as a mode of spread, occurring in no more than 6 percent of children of hepatitis C positive mothers. Around 2 percent of all cases of hepatitis C are thought to be contracted through the occupational risk (needle-stick injuries, blood spills, etc.) involved with the health care profession. "Some skin piercing practices, notably tattooing, body piercing, and acupuncture, have contributed significantly to the spread of HCV, particularly in less industrialized nations. Tattooing in particular poses a serious risk. Even in the presence of good sterilization, studies have suggested that the ink used in tattooing can become contaminated and transmit the virus. "Several studies have shown that adequate blood can be present in other body secretions to transmit infection. Cocaine users have an abnormally high risk of infection due to the fact that they frequently share snorting straws, which may have small amounts of blood-carrying mucous on them. Such indirect sources of blood may explain many cases of inter-household transmission. Less obvious, specialized risk factors have been identified resulting from indirect exposures to blood, including manicures, shared toothbrushes and razors, and straight razors in barber shops." (From the C. Everett Koop Institute at Dartmouth web site.) There is also about 2 percent of all HCV cases where the source is unknown. Hepatitis C effects the liver, often leading to cirrhosis -- and death. There is no vaccine and no completely effective treatment. The side effects of the treatment of HCV are often worse than the disease since HCV patients often have no symptoms. The side effects from the treatment include -- but not limited to -- flu-like symptoms, thinning hair, depression, fatigue and nausea. All this and more from a self-injected treatment three times a week to once a day for anywhere from six to 18 months! And when treatment is completed, the patient may still have HCV. I was diagnosed in March of 1999 as having HCV. The virus has started to effect my liver, so I could have been carrying it for many years. I do not know how I got HCV. I have never done IV drugs or cocaine and I do not have tattoos. I did work in the health field from 1974-1976, long before gloves were standard procedure. Or I may have contracted HCV through sexual relationships, although many current studies show that sexual contact is one of the least common ways of contracting the disease. People who have hepatitis C need be aware that their blood and possibly other body fluids are potentially infective. Care should be taken to avoid blood exposure to others by sharing toothbrushes, razors, needles, etc. All people should take care to keep all cuts and open wounds covered. It only takes a drop of infected blood to enter a healthy persons blood and the cycle continues. I now keep gloves in all the medicine cabinets at home and in the first aid kit in the car. I take extra care when tending to my children's cuts and scrapes, making sure I do not have any cuts on my hands that may spread the disease to my kids. Women need to take extra care during menstruation, making sure that used products are safe from the family pet and that there is no "leakage" on toilet seats, etc. In preventing the spread of HCV the important factor is blood to blood contact. Ways in which HCV cannot be spread are: The Hepatitis C virus is NOT airborne. It is not spread by: sneezing and coughing, holding hands, kissing, using the same bathroom, eating food prepared by someone with HCV, holding a child in your arms, swimming in the same pool. Unfortunately, none of this information came to me from my doctors. In fact, I have received no education from my doctors here in the Greater New Bedford area concerning this illness. It's no wonder it is at epidemic proportions! Much is still unknown about the hepatitis C virus, and many physicians have not had much experience treating it. Unfortunately, in a community like New Bedford that has such a high percentage of drug users and HCV cases, it is important that every doctor learn all the facts about this disease. HCV patients are facing a life-long, sometimes life-threatening, disease that has no completely effective cure. We need knowledgeable and compassionate doctors and health care professionals who are willing to counsel their patients on the prevention of this disease the same way people with STD, HIV or any other communicable disease are counseled. - --- MAP posted-by: Keith Brilhart