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IV drug use blamed for outbreak of hepatitis C

Drug abuse among youth cited; prevention urged by officials

What can we do about this outbreak of hepatitis C in Park County?”

That’s one of the questions posed by Wyoming Department of Health Viral Hepatitis Prevention Coordinator Ashley Grajczyk as she describes an unexpected surge in local reports of the disease.

In 2012, there were 56 new reports of hepatitis C infections in the county — roughly double from the year before, putting the county’s rate of new infections substantially above the state average, according to Department of Health data. Around 39 percent of the 2012 reports came from the Powell area, with the remaining 61 percent coming from Cody, Grajczyk said.

Department of Health data shows the spike is generally attributable to newly reported infections among younger people between the ages of 20 and 34.

Hepatitis C is transmitted by blood, and the department’s data suggests the disease is generally being picked up by individuals sharing equipment while using drugs. It’s possible a part of the new reports are from out-of-area residents who come to Park County for substance abuse treatment, but it’s not known how much that has contributed. The county’s rate has been rising since 2008, Grajczyk said.

“We’re talking about hepatitis C here, but in reality it is at-risk kids, 15 to 30, who are doing all kinds of things that maybe we don’t want to acknowledge, or we know about but don’t know what to do about,” said Park County Public Health Nurse Manager Bill Crampton.

Crampton and Grajczyk spoke at a Nov. 7 meeting of the Park County Health Coalition in Powell, looking for ideas on how to stop the continued spread of the disease and how to help those already infected.

The Department of Health and Public Health spearheaded a campaign in May to raise awareness of the problem by hanging posters around the county. The poster’s message, as Grajczyk describes it, was “if you’re injecting drugs, you may be at risk for communicable diseases and hepatitis.”

But cases continued to crop up and “we’re seeing that we need to make further efforts,” Crampton said.

“Hepatitis C is for life. You can put it into remission. You can live with it. You can live a full and healthy life,” Crampton said later on in the meeting. “But you may need treatment for some of these folks that will bear hepatitis C badly and how do we assist them?”

Once contracted through a contaminated needle, blood transfusion, a non-professional tattoo needle or other blood-to-blood contact, hepatitis C begins to attack the liver. In the initial stages, an infected individual is unlikely to display any symptoms. However, the infection typically progresses over a course of years from that “acute” stage to a “chronic” one, where the patient may have elevated liver enzymes and feel joint pain, fatigue and chronic abdominal pain.

Liver damage or cancer can result from the disease.

“Some people can live with it for 40 to 50 years and live a full life, but then again, there are individuals who can actually die from this infection,” Grajczyk said.

Hepatitis C is treatable, but the treatment is expensive. Those high costs loom large given that, according to Grajczyk, many of the people infected are under- or un-insured.

Finding a way to provide treatment to those individuals — whether through telemedicine or a local medical provider — was one of the ideas for which Grajczyk sought input.

Increasing awareness and screening for the disease are other prongs of the plan. That may include finding health-care providers to donate resources such as testing supplies to check for hepatitis C infections.

But prevention of new infections altogether is the ultimate goal.

Crampton and Grajczyk said the effort needs to include more organizations, finding others to further the work of groups such as Northwest Wyoming Family Planning.

“We have realized that it is much bigger than these few organizations. It really is going to be a community effort when we talk about prevention activities,” Grajczyk said.

Crampton suggested education efforts though Park County Youth Services, Northwest College, local schools and substance abuse treatment providers.

In addition to warning of the dangers of using illegal drugs and sharing needles, part of the messaging may include advice on how to clean drug-injecting equipment and avoid disease.

“We may not be able to modify them and get them to stop injecting, but if they clean their equipment with bleach, you know, at least we’re making another step,” Crampton said. “Does that mean we’re promoting the idea? No, we’re not promoting the idea, but there’s just some folks that aren’t going to listen to us. We can at least break the chain at some point.”

Tai Wright, a field epidemiologist at the Wyoming Department of Health, said it’s a model of harm reduction. While health officials ultimately want individuals to stop injecting drugs, there is education that can be provided on ways to make the use more safe, Wright said.

“It’d be a wonderful world to think that they can go into a treatment program for 30 days or even a year and they come out and it’s never going to happen again, but harm reduction ... you’re going to have to go there at some point because that’s the reality,” said another woman at the meeting who’s worked with drug addicts locally. “Because it’s a sad, sad state of affairs for a lot of people.”

West Park Hospital prevention specialist Helena De Fina added that receiving education about safety could one day lead to a person quitting.

“You never know,” said Crampton. “It’s astonishing what saying one thing to one person affects somebody two people down the chain — and you never realize you had that effect.”

Powell Police Chief Roy Eckerdt asked whether it would help for the state to start regulating tattoo parlors, but Wright responded that “there’s no data to support that these diseases are coming from store-front tattoo parlors.”

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3 comments

  • posted by Jessica Gillespie

    December 03, 2013 1:40 pm

    JASON PINGEL.... VERY WELL SAID!! THANK YOU FOR YOUR UP FRONT MESSAGE THAT EVERYONE NEEDS TO KNOW THE TRUTH ABOUT AND HEAR IT WETHER WE LIKE IT OR NOT!! I appreciate your honesty and coming out to tell people about this very seriously scarey outbreak! Jason said it exactly right in every aspect!! We all need to come together and HELP these people/kids, and not just labeling them bad people and throwing them away. They are God's children just as much as any of us. So we can stop this outbreak of hepatitis C if we help our kids and our future kids to make sure they know that they can always be honest and trust us enough to talk about these things! We HAVE to educate them in every way possible to make them aware and realize this dangerous situation that they absolutely CAN avoid!! We need to be here for all the people who presently have Hepatitis C and make sure they get all the help they need. Its not just the younger group who have this disease... the era of the baby boomers have it and the majority of the people don't know they have it. So its just as important they also get checked, regardless if they show any symptoms. If people know how horrible this disease really is and the horrific treatment you have to endure, everyone would take this much more seriously! Unfortunately I know people with this disease and the struggles they go thru. So this is close at heart and all I ask is to be aware cause we can cure this. Thank you and God bless.

  • posted by Jason Pingel

    November 20, 2013 11:10 am

    Well good job Park County. I have been warning people in the community of this impending hepatitis outbreak for the last 3-4 years, and yes it is mainly due to intravenous drug use. The sad thing is that this whole situation could have been prevented. This whole mess could have been avoided by spreading information and awareness as well as having a little compassion for your fellow man.
    I will tell you from personal experience (being a young person who grew up in the Big Horn Basin) it is not just the "at risk kids" that are getting this disease or that are behaving in this dangerous manner. Intravenous drug use has been on the rise in the Park County area for at least the last 5-6 years (from what I have witnessed), and the way the youth views intravenous drug use has changed since I was in high school 10 years ago. Unfortunately it did not change for the better.
    I remember when I was younger; there were a select few people that engaged in this unsafe and risky behavior. However even these people were not proud of it, and most of the IV drug use was kept hidden behind closed doors. People did not talk about it with others who did not use intravenous drugs, and they damn sure were not proud of it. It was kind of like an inclusive club that only a select few people were members too (at least in the Cody area).
    It is a very different scene now, and the youth looks at this behavior quite differently. From what I have seen, the younger generation does not view IV drug use as more dangerous than typical drug use. IV drug use has become the “in-thing” around this area. It is so sad, but it is so true and if you don’t believe me all you have to do is ask your children. I would be willing to bet, if you have kids in the high school, they probably know at least one person that uses needles to take their drugs on a regular basis. Don’t take my word for it, go ask your kids. That is why all of the sudden you are have good kids, from good families, that are getting arrested for such serious crimes as robbing pharmacies, robbing people, threating people with knifes/guns, and yes even murder.
    Just because we live in a rural part of the country doesn't mean that we are immune to the problems that occur elsewhere in the world. In all reality it could mean that we are at a bigger risk. At least in the city people screen for Hep C and they have programs for people who are addicted to IV drugs (so they can get information how to be as safe as possible when acting in this manner). It is a conversation that is in open dialog with the community in most areas, instead of being a dirty little secret that people don’t talk about. That is what IV drug use has become in this area, the dirty little secret that no one discusses. It is happening right here, in the middle of God’s country, and in our backyard.
    Our kids are so scared about being arrested that they hide their addiction instead of being honest about it like they should. This causes people who are using substances in this way to be so afraid of getting caught that they would rather keep using old needles (or sharing with a fellow user) rather than run the risk of purchasing clean needles and getting labeled as a IV drug addict. Instead they keep using the old ones until they literally beak off in their vein, or they share with any idiot who has a needle (and probably hepatitis C, HIV, AIDs, and lord knows what other diseases).
    Perhaps we should start worrying about the people who are addicted, and their safety, instead of labeling people as degenerates and shipping them off to prison. Addiction is unbiased; it doesn't care your age, sex, race, religion, or the like. It can affect anyone at any time in their life. Addiction doesn’t care whether it is your kid sticking themselves with a dirty needle or if it is mine. We need to let our kids know that they can talk to us about anything including their addiction, without fear of persecution. Let’s put the criminals in jail, and help our kids regain their independence, health, so they can achieve their goals and so they can live life free from addiction.

  • posted by Salty Dawg

    November 19, 2013 9:33 am

    You play with fire,you will get burned sooner or later.

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