Hepatitis C cases are on the rise in Washington state, and Walla Walla County is no exception.
Why this is happening here, however, is not easy to pinpoint, officials have said. It could be an increase in testing and awareness, but the higher numbers could also be linked to the Washington State Penitentiary, since the county’s statistics include inmates housed at the prison.
Between 2009 and 2017, the number of chronic cases of hepatitis C, which is primarily spread through blood, increased by 60 percent statewide from 5,511 to 8,839 cases. The numbers have also jumped in Walla Walla County.
According to Meghan DeBolt, county Community Health Department director, there were 36 chronic hepatitis C cases in 2013 and 2014. That number increased to 41 in 2015, decreased to 26 in 2016 and then jumped to 40 in 2017.
The 2018 numbers are incomplete because in July of that year the state switched to a new reporting system, DeBolt said. But from July 2018 to December there were 92 cases reported, and there have been 57 new cases for 2019 so far this year.
“So, we are seeing an increase, nearly double, in chronic (hepatitis C cases) in 2018 and 2019,” DeBolt said in an email. However, she noted, “this could be in part due to an increase in awareness, surveillance and testing.”
The local numbers are also increased because Walla Walla County includes cases detected among inmates at the Washington State Penitentiary, DeBolt said. Numbers of cases reported by the state Department of Health do not include information on Department of Corrections inmates.
Health officials say baby boomers, defined as people born between 1945 and 1965, and persons who inject drugs are at higher risk of having or acquiring hepatitis C infection. The Centers for Disease Control and Prevention recommends everyone born between 1945 and 1965 be tested for hepatitis C.
DeBolt said anyone who thinks they should be tested for hepatitis C should talk to their doctor or, if they do not have a personal care physician, they can call the county Community Health Department at 524-2650.
According to the CDC, hepatitis C is often described as “acute,” meaning a new infection, or “chronic,” meaning lifelong infection. Most acute cases show no symptoms, but about 20 percent have an abrupt onset with fever, abdominal pain and jaundice.
Chronic infection follows an acute infection and also typically exhibits no symptoms until complications such as liver damage or cancer develop after decades. About 75-85 percent of people who become infected with hepatitis C virus will develop a chronic infection.
As reported by the Seattle Times Monday, because hepatitis C is spread through blood, this means the virus is often contracted when people share needles. That has contributed to the recent rise among intravenous drug users, but it also can help explain the disease’s prevalence among boomers, who came of age at a time when needles were reused for drugs and other things, such as tattoos.
“It was sex, drugs and rock ’n’ roll. It was the ’60s and ’70s,” Dr. John Scott, director of the Hepatitis and Liver Clinic at Harborview Medical Center, told the Times.
Also leaving boomers vulnerable was the fact that the country’s blood supply wasn’t screened for hepatitis C until 1992, the Times reported.
Fortunately, advances in medicine in recent years have resulted in hepatitis C treatments that have dramatically changed survival rates. Although expensive, antiviral medications taken for eight to 12 weeks have shown a success rate of 99 percent.