HEPATITIS C ON THE RISE AMONG OPIATE ABUSERS

Of all infectious diseases, hepatitis C has been one of the least worrisome
in West Virginia. In all of 2001, for instance, only 26 people in the entire
state were diagnosed with acute hepatitis C.

But in Mercer County, 27 people recently were diagnosed with hepatitis C -
in one week.

"It's horrible," county health director Kathy Wides said. "We're seeing 10
to 40 [new cases] a month."

Conversely, hepatitis C has gone down 80 percent nationwide since 1989,
according to the national Centers for Disease Control and Prevention.

What's causing the spike in Mercer County? OxyContin abuse, Wides said.

"Most of the hepatitis C is [spread by] sharing sharp straws" when snorting
crushed-up pills, she said.

That's one reason Wides would love to see a proposed methadone clinic open
in Mercer County. The controversial clinics, which have sprouted up across
West Virginia over the past two years, sell methadone (a synthetic opiate
drug) to people who abuse illegal opiates, thereby quelling their cravings
for the illegal drugs.

Indeed, one of the best ways to corral the hepatitis C virus is "anything
communities can do to reduce the risk that people will abuse drugs," state
epidemiologist Diane Bixler said.

Hepatitis C attacks the liver. The CDC says it is a leading reason for liver
transplants.

Seventy-five to 85 percent of infected people develop chronic infections,
and 70 percent get chronic liver disease from the virus. If left untreated,
hepatitis C can be fatal.

Unfortunately, it's also very difficult to detect, Bixler said.

"It is a silent infection in a lot of folks," she said. The symptoms are
pretty generic: fatigue, abdominal pain, nausea.

Eighty percent of people with hepatitis C have no symptoms at all.

Since 2000, about 2,700 cases of chronic hepatitis C have been identified
statewide - a rough estimate, Bixler said. "A lot of cases, we're not going
to know about," she said.

Twenty-two West Virginia counties haven't reported a single case of
hepatitis C in eight years. That doesn't mean it's not there. It just means
nobody's found it, Bixler said.

In fact, "some of the counties with higher rates may just be doing a better
job with surveillance," she said.

Hepatitis C is spread by contact with the blood of an infected person.
Bixler estimated that 60 percent of cases are spread by sharing drug
paraphernalia.

"Another 21 percent may be transmitted sexually," she said. "We're talking
about high-risk sexual activity." If an infected person has a long-term
monogamous partner, the possibility that the partner will catch the disease
is extremely slim - about 1 percent.

The risk from blood transfusions and organ transplants is just as slim,
Bixler said. A hepatitis C-infected mother has a 5 percent chance of passing
the disease to her infant.

People who try to give themselves tattoos at home also are at risk for
hepatitis C, Wides said. Clean tattoo and piercing parlors don't carry that
risk.