HEPATITIS MENACE DIFFICULT TO TRACK

For Catheleen Healey of Homewood, the initial shock of being diagnosed with
the hepatitis C virus in 1990 was followed by an even more dreadful
realization: she probably had spread the potentially deadly infection to
many unsuspecting victims.

Healey, 60, had led the annual blood drive at the South Side elementary
school where she taught for 10 years in the 1970s and early 1980s, and
always did her part by being the first to roll up her sleeve and donate.
Although blood screening now rules out anyone who comes up positive for
hepatitis C, the virus flowed freely among transfusion patients before 1992,
when such tests became standard.

"That gave me tremendous guilt," Healey said. "My husband kept reminding me
that I didn't know I was infected. I couldn't have."

While Healey found out that she had the virus through a routine blood test
at her doctor's office, hundreds of thousands of others infected across the
country still do not know that they are part of a huge, yet unheralded,
epidemic. They are the targets of a massive federal initiative announced
last week by the Centers for Disease Control and Prevention to help blood
banks and hospitals identify all those who received blood tainted with the
virus before 1992.

Even more daunting is the chore of getting word out to the millions who
received transfusions so long ago that records of their treatment no longer
exist, as well as intravenous drug users, who make up the largest single
infected group.

The long-standing hepatitis C threat only now is registering on the public
radar because new treatments have made it more important than ever for
health officials to identify the estimated 4 million Americans infected with
the virus--including 180,000 in Illinois. In June, the Food and Drug
Administration approved a combination of the potent anti-viral drug
interferon and a new drug called ribavirin, which experts believe could
reduce hepatitis C virus (HCV) to undetectable levels in half of all
patients.

Hepatitis C is the leading reason for liver transplants in the United
States, accounting for half of the 4,000 performed each year.

"Putting the two drugs together has doubled our success rate," said Dr.
Elizabeth Fagan, a liver disease specialist at Rush-Presbyterian-St. Luke's
Medical Center. "It's a major advance."

Such success has the drug combination's maker, Schering-Plough Corp.,
splashing full-page color newspaper ads to encourage people at risk to get
tested. Other drug companies are scrambling to develop the next generation
of HCV remedies, including a longer-lasting version of interferon and drugs
modeled after the protease inhibitors that have revolutionized treatment of
HIV, the virus that causes AIDS.

But even such efforts do not do justice to the scale of the HCV epidemic.
Although the number of people with HCV is four times higher than those with
the AIDS virus, and death rates for the two diseases are converging, with
10,000 deaths a year for hepatitis C and 16,000 for AIDS, federal funding
for hepatitis C research is relatively paltry. Such efforts will grow to a
new high of $34 million in 1999--still puny compared to the $1.4 billion
spent to fight AIDS.

Of the three types of hepatitis, hepatitis C is the most common, accounts
for the most deaths and is the only one for which no vaccine exists.
Hepatitis A is spread by food and rarely causes serious illness, while
blood-borne hepatitis B affects about 1 million people in this country.

Identified for the first time in 1989, hepatitis C is spread by blood
exchange and, more rarely, by sexual contact. The virus targets cells in the
liver, causing scarring, cirrhosis or cancer in about one-fifth of those
infected.

A sampling of HCV patients in the Chicago area reveals a true cross-section
of American life:

- - John Schwemm retired as chairman and CEO of Chicago printing giant R.R.
Donnelley & Sons in 1988 because his doctor told him that HCV would kill him
within three years. Schwemm, 64, who believes he got the virus while
swimming in polluted waters, said the disease is especially insidious
because no symptoms may be felt before serious damage sets in.

"They claim you might feel tired, but if you're in a job like most of us you
feel tired anyway," said Schwemm, who has survived thanks in part to a liver
transplant.

- - Larry LaFrank, 42, was recently diagnosed with HCV at Loyola University
Medical Center in Maywood and is feeling better after starting on high doses
of interferon. The truck driver from Wilmington, Ill., said he might have
contracted the virus while getting a tattoo or during a sexual encounter
while traveling.

"It could have been a woman from just about anywhere in the country,"
LaFrank said.

- - K.C., a 42-year-old clerical worker from Chicago, believes she got the
virus shooting heroin intravenously in the early 1970s. Like Healey, she
fears she spread HCV to others through blood donations before she was
diagnosed in 1995.

The virus has seared Healey's family. Healey's mother passed hepatitis C to
all three daughters during childbirth, thus lighting a viral fuse that often
takes many decades to detonate.

Healey's mother died of liver cancer in 1988. Her sister Arlene died after
two liver transplants, and her sister Sonnie is trying out the new drug
combination. Healey, who became chairwoman of the American Liver
Foundation's Illinois chapter, is on the waiting list for a liver
transplant.

Chicago-area blood bank officials are sifting through thousands of records
from blood donors who screened positive for hepatitis C after tests became
available in 1992. Their aim is to find those who gave blood before the
tests were widespread.

The job is especially vexing because blood from one infected person can find
its way into a plethora of blood products, making the notification process
labyrinthine.

"The task looks on paper to be about 1,000 people we have to reach in the
Chicago area, but that could grow to as many as 10,000 potential
notifications," said Dr. Joseph Kiss, medical director of the Institute for
Transfusion Medicine, which is advising the Chicago-based blood bank
LifeSource on how to track infected donors.

Assuming that hospitals that used the infected blood can find patients who
may have moved since their transfusions, convincing people to get tested
still may prove difficult. The fact that intravenous drug users account for
60 percent of new cases creates a stigma for all victims.

Well-respected HCV sufferers such as Schwemm, Healey and even country music
star Naomi Judd may help the disease finally get the attention it merits,
but access to good health care and accurate information may not reach those
who need it most.

On a recent visit to the Southeast Side neighborhood where she used to shoot
drugs, K.C. learned that four of her old companions also were infected with
HCV. She tried to persuade one, a woman, to seek treatment and stop drinking
alcohol, which could speed the deterioration of her liver.

"She kept saying, `I'm not sick, I'm not affected by it,' " K.C. said. "And
then she downed another drink of whiskey."

Checked-by: Rolf Ernst