Pubdate: Mon, 1 Feb 2010 Source: Record, The (Stockton, CA) Copyright: 2010 The Record Contact: http://www.recordnet.com/apps/pbcs.dll/section?Category=A_OPINION05 Website: http://www.recordnet.com/ Details: http://www.mapinc.org/media/428 Author: Joe Goldeen, Record Staff Writer Bookmark: http://www.mapinc.org/topic/hepatitis Bookmark: http://www.mapinc.org/find?137 (Needle Exchange) CALIF. OFFICIALS STEP UP THE FIGHT AGAINST HEPATITIS STOCKTON - With a new strategic plan in place, California public health officials hope to break the silence about hepatitis. "It's important to recognize that viral hepatitis is a significant and costly public health problem. Most people who are infected have no symptoms and are completely unaware of their status. We have been silent too long about the problem," said Dr. Gail Bolan, chief of the Sexually Transmitted Diseases Control Branch of the state Department of Public Health. Dr. Karen Furst, health officer with San Joaquin County's Public Health Services, said, "The ultimate control is prevention. We still have a lot of folks out there who don't know they are infected. So it's important to identify those people at high risk." Hepatitis - inflammation of the liver caused by a viral infection - can lead to liver disease such as cirrhosis and liver cancer. The three most common viruses are hepatitis A, hepatitis B and hepatitis C. According to the federal Centers for Disease Control and Prevention, viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplants. In the United States, an estimated 1.2 million Americans are living with chronic hepatitis B and 3.2 million are living with chronic hepatitis C. Earlier this month, Bolan's agency released a comprehensive planning document. Among key findings: . The need for awareness of what hepatitis is, how it is transmitted, the availability of simple screening tests and effective vaccination (except for hepatitis C, for which there is no vaccine). . In 2007, state hospitalizations for hepatitis B and C cost $2 billion. . The incidence of liver cancer over the next 20 years is expected to increase 59 percent and be highest among Latinos, Asian Americans and Pacific Islanders. People with hepatitis A have symptoms ranging from a mild illness lasting a few weeks to severe health problems lasting months. It is usually spread when a person ingests fecal matter from contact with contaminated objects, food or drinks. It can be prevented through vaccination. As a reportable disease, there were 10 cases of hepatitis A in San Joaquin County during 2008, the last year for available data. Statistics show the disease steadily in decline the past 10 years except for outbreaks in 2001 and 2005. Hepatitis B, on the other hand, is usually spread when blood, semen or another body fluid from an infected person enters the body of someone who is not infected. This can happen through sexual contact, sharing drug needles or from an infected mother to her baby at birth. Acute hepatitis B is a short-term illness that usually occurs within six months of exposure and can - but does not always - lead to chronic infection. Chronic hepatitis B remains in the body long term, leading to serious health problems and even death. An effective vaccine preventing hepatitis B has been available since 1982. In 2008, there were eight new cases of acute hepatitis B reported in San Joaquin County. There was a high of 49 cases in 2002. There were 220 cases in the county of chronic hepatitis B in 2008, showing little change over the previous two years. The county's efforts to break the cycle of transmission between infected mother and baby are working exceptionally well, according to Furst. Doctors are required to test pregnant women for hepatitis B. "They have very good efficacy for preventing the baby from getting chronic hepatitis B," Furst said. In addition, "we evaluate the whole family. If there are no (hepatitis) infections, we vaccinate," Furst said. Most people at risk today for hepatitis B are in their 30s or older, since most young people have been vaccinated. Hepatitis C is the nation's most common chronic blood-borne infection. During 2008, there were 1,819 cases reported in the county. That's almost double the 931 cases reported in 2007, but the reporting pool grew when clinical laboratories were first required to report cases in addition to physicians. Furst also noted that county numbers are skewed higher because of the presence of Deuel Vocational Institution near Tracy, a large state prison. According to the state report, approximately 55,000 of the more than 150,000 people incarcerated in California prisons have hepatitis C. Hepatitis C is primarily transmitted through dirty syringes commonly shared among intravenous drug users. Dr. Aziz Khambati, an internal medicine physician who has been with downtown Stockton's Channel Medical Center for 14 years, sees about 25 patients with hepatitis C. Most acquired the disease because they were sharing needles. "I see a need for a clean needle-exchange program along with a strong educational element. I would advocate for education," Khambati said. Stockton and San Joaquin County are among the largest jurisdictions in the state without an authorized needle-exchange program. Advocates say it is the simplest way to prevent the spread of hepatitis C. [sidebar] TO LEARN MORE California Hepatitis Alliance: www.calhep.org California Department of Public Health: www.cdph.ca.gov/programs/Pages/ovhp.aspx Federal Centers for Disease Control and Prevention: www.cdc.gov/hepatitis - --- MAP posted-by: Richard Lake