N.H. plans to start tracking new cases of hepatitis C

First, there’s a heroin epidemic. Then, there’s a surge in hepatitis C cases.

That’s the scenario that worries New Hampshire health officials, who fear the infectious disease will spread quickly among drug users who share needles.

“It’s a very high percentage of people that within a month of sharing needles will convert to being positive for hepatitis C,” said Democratic Rep. Thomas Sherman, a Rye doctor. “You can imagine the scope of the problem with the opiate epidemic. It’s going to be huge.”

But right now, no one knows the size the problem, or how many people in the state are even infected with the liver-destroying disease.

That’s because unlike other forms of hepatitis, New Hampshire has never tracked hepatitis C.

Now, as rates of the disease continue to rise nationally and the state confronts a major heroin problem, New Hampshire’s public health department is changing course. The state plans to start tracking new cases of hepatitis C within the next year to help officials identify outbreaks, implement effective prevention measures and connect people who become infected with care and treatment.

Public health officials and health care providers say the policy shift will help them develop targeted, cost-effective prevention strategies.

“As we look at making decisions based on data, that is going to be another key piece,” said Timothy Soucy, director of the Manchester Health Department. “With limited resources and time, we want to make sure we’re putting resources into the correct things.”

It’s not clear whether hepatitis C has already become a major health problem among drug users.

Manchester, at the center of the state’s substance abuse epidemic, has yet to experience a rise in hepatitis C cases, Soucy said. But the city is starting to see warning signs. This year alone, officials picked up more than 500 discarded needles across the city. Manchester officials are trying to get a handle on the problem by setting up a free, walk-in system to test people for the contagious disease.

Sherman has already seen two patients who are actively using drugs and recently became infected with hepatitis C.

“One hopes (an outbreak) doesn’t happen,” said Tym Rourke, chairman of the Governor’s Commission on Alcohol and Drug Abuse Prevention, Treatment, and Recovery. “All it takes is one infected patient.”

Hepatitis C is the most common blood-borne infection in the country and affects nearly 3 million people, according to the Centers for Disease Control and Prevention. The disease is primarily spread through contact with an infected person’s blood, making intravenous drug users especially susceptible.

Overtime, the disease can lead to long-term health problems, including liver cancer, and nationwide hepatitis C is the leading cause of liver transplants.

While there’s no vaccine to prevent the disease, new prescription drugs can effectively cure it. But those treatments are costly, priced at roughly $100,000 for a course of treatment.

Without effective prevention efforts, some say, the state could be looking at a huge health care bill.

“Think of all the people getting infected who are going to need that drug,” Sherman said. “Think of the cost that is going to be for the state.”

While the CDC recommends that states track cases of hepatitis C, New Hampshire is one of a handful of states that hasn’t. As a result, state officials haven’t had concrete data on how many residents have the disease, or how many new cases spring up each year.

The Division of Public Health Services plans to start tracking the disease next year, by making health care providers notify the state when they find a patient who has a new case of hepatitis C. Physicians would not have to report people with chronic hepatitis C, meaning they contracted it a long time ago.

The information would help the state identify new outbreaks and stop the spread.

“This is the way we prevent some of the sequel,” Sherman said. “We’re focusing right now on 28 people dying a month (from overdoses), but we’re not focusing on some of the other collateral damage.”



(Allie Morris can be reached at 369-3307 or at amorris@cmonitor.com.)