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Hepatitis C Cases in Northern Kentucky Continue to Rise; Needle Exchange Sees Starts, Stops

Northern Kentucky now has one of the highest rates of hepatitis C infection in the nation.

That's according to the Northern Kentucky Health Department which counted 1,100 cases diagnosed in 2015. The increase in hep C cases is directly related to the region's ongoing battle with heroin use and the associated sharing of tainted needles.

On Monday, the Grant County Fiscal Court approved a resolution in support of a syringe access exchange program, joining its city of Williamstown. By state law, adopted in 2015, a syringe access/needle exchange program can be launched in a community where a city and a county each approve. Grant joins nearby Pendleton County in creating such an effort.

In Boone, Kenton, and Campbell Counties, however, there have been no formal votes on placing such a program in a specific community. Last week, Health Department director Dr. Lynne Saddler joined St. Elizabeth Healthcare CEO Garrin Colvin in arguing for such a program in Covington, but the city commission was cold to the idea.

One possible location for a needle exchange in Covington is at the Health Department's offices at 20th Street & Madison Avenue.

"One of the concerns we have at 20th and Madison, we'll have several hundred heroin addicts, high on heroin driving at 20th and Madison," Covington City Commissioner Chuck Eilerman said. "We are very concerned about putting that type of clientele at 20th and Madison. I would rather see it put out in areas where it is less close to residents and schools."

Commissioner Bill Wells suggested a mobile exchange unit.

"The needle exchange needs to be run through the local health department with city and county permission. That's why we're here," Colvin told to the city commission. "If we try to move it out of the health department -- most of those professionals in the health department are dually skilled, move it out and we're replicating all those costs. $1 million on an annual basis. Half the people that will utilize this program are using the health department for other services."

The urgency is serious: It's not just heroin users that are subject to contracting Hepatitis C. "A dirty needle sitting on a park bench will carry hep C, not just the needle point. If you had a cut, you are subject to hep C infection," Colvin said. 
 
City Commissioners Steve Frank and Jordan Huizenga said that city leaders may be reflecting the general disapproval of further carrying the region's social services burden. Colvin suggested that all three counties may be trying to coordinate to allow for needle exchanges around the same time. Commissioner Wells said that the regional smoking ban was a similar effort but when the smoke cleared, or didn't, only Kenton had a law on the books.
 
Meanwhile, the Health Department plans to offer the program at its Grant County Health Center, located at 234 Barnes Road in Williamstown. An exact start date is to be determined.
 
“Our region’s on-going struggle with hepatitis C is closely tied to our high rates of intravenous drug use, especially heroin,” said Saddler. “People who use IV drugs can expose themselves to the disease when they share needles and syringes. Hepatitis C is easily transmitted from one person to another when injecting. We must employ specific tactics if we are going to stop the spread of this disease, including syringe access exchange programs, providing greater access to infectious disease testing and working to help people with addiction get both the medical care and substance abuse treatment they need. In Grant County, the hepatitis C testing will be available as part of a larger, more comprehensive syringe access exchange program, as well as for anyone else who wants to be tested. At the health centers in Boone, Campbell and Kenton counties, increased access to testing can still help individuals learn if they are infected, and if so, take steps to prevent further transmission.”

Cases of hepatitis C continue to rise in Boone, Campbell, Grant and Kenton Counties. In 2015, a total of 1,132 people were diagnosed with either acute or non-acute hepatitis C, according to preliminary case reports. This is an increase of 27 percent from 2014, when a total of 891 cases were reported. In 2014, Northern Kentucky had one of the highest rates of acute hepatitis C infection in the country, with a case rate of 10.9 per 100,000 population, compared to 2.68 per 100,000 in Kentucky and 0.55 per 100,000 nationwide (state and national rates for 2015 are not yet available).

Hepatitis C is a contagious liver disease that ranges in severity from a mild illness lasting a few weeks to a serious, lifelong illness that attacks the liver. It is caused by a virus that is spread when blood from an infected person enters the body of someone who is not infected. Most people with hepatitis C do not have any symptoms. Some people, however, can have mild to severe symptoms soon after being infected, including fever, fatigue, loss of appetite, nausea and vomiting. Treatment is available, but left untreated hepatitis C can progress on to liver cancer or cirrhosis, resulting in the need for a liver transplant.

People often become infected with the hepatitis C virus through sharing needles, syringes, or other equipment to inject drugs or by getting tattoos or piercings with unsterile equipment—which are common sources of exposure based on the cases reported in Northern Kentucky. Other less common methods of transmission include needlestick injuries in health care settings, being born to a mother who has hepatitis C, sharing of personal items--such as razors and toothbrushes--with an infected person, and through unprotected sexual contact with an infected person.

“If you are a current or former IV drug user, if you have liver disease or if you have HIV, you should get tested for hepatitis C. If you know someone in one of these groups, please encourage him/her to be tested as well,” said Saddler. “Diagnosis of the infection can be the first step in changing a person’s lifestyle to prevent serious damage to the liver and avoid passing the virus on to other people.”

Testing will be available to anyone who thinks he/she may be at risk of infection by calling for an appointment. Locations and numbers are listed below.

  • Boone County Health Center, 7505 Burlington Pike, Florence, 859.363.2060
  • Campbell County Health Center, 1098 Monmouth St., Newport, 859.431.1704
  • Grant County Health Center, 234 Barnes Road, Williamstown, 859.824.5074
  • Kenton County Health Center, 2002 Madison Ave., Covington, 859.431.3345

A vial of blood will be drawn for the test, with results available in a few days. Patients will be provided with education about hepatitis C during their visit as well. Fees for the screening will be charged on a sliding scale based on the person’s income and household size, as well as other services required. Kentucky Medicaid is accepted and will be billed for those who are eligible. No one will be turned away for inability to pay.

For more information on hepatitis C and other strategies to reduce infectious diseases caused by IV drug use, please visit http://www.nkyhealth.org.

-Michael Monks, editor & publisher, with quotes from city commission meeting; Additional information from NKY Health Department