Main risk factors for exposure to viral hepatitis:
Contaminated blood: whole blood (especially any blood products received before 1992), clotting factor (pre-1987), shared IV drug needles…think anything that might have blood cells on it….razors, toothbrushes, nail clippers, cuticle scissors (B & C)
Experimenting with drugs (even once) and/or sharing a straw to inhale cocaine (B & C)
Contaminated food, water or other poorly sanitized items (A & E)
Mother to child (vertical) transmission (mostly HBV, more rarely HCV)
Unprotected sex with multiple or higher-risk partners, MSM sex (B & C)
Tattoos and piercings (B & C)
Military service innoculations and/or treatment for injuries received in the field (B & C)
Any invasive medical treatment received outside the U.S., especially blood products (B & C)
Extended periods of dialysis (mostly B, some C)
Household contact (A, B & E)
Born to parents of Asian-Pacific Islander descent – either abroad or here. One in every 12 API’s is infected with HBV.
Now, just in case you’re sitting there feeling all smug and complacent and thinking, “Ha! None of those apply to me!”…..let me tell you about the Las Vegas endoscopy clinic that was in the news a few years ago. The clinic that reused not needles, but syringes, thereby contaminating multi-dose vials of medication. They reused the wire loops used to snip colon polyps and the bite-blocks used for endoscopies. 40,000 people were notified that they may have been exposed to HBV, HCV or HIV. Roughly 4,700 people went and got tested, 125 or so were infected with HCV. That’s really a pretty high ratio – over 3%. I suspect I know why more people didn’t go get tested. Because they got the letter and thought, “I feel fine. I don’t need to get tested.”. HCV…..silent and insidious.
Shall we go on to talk about New York (inadequately sterilized equipment at a dental office), Miami (cleaned endoscopy equipment once a day…yuck!), Boulder (drug addicted surgery tech infected 35 people), Alberta, Oklahoma, Michigan, England, Australia……? No? Had enough? Are you sure? There’s more – wanna hear about ‘em? Scared yet? You should be. I am not, by the way, insinuating anything about any facilities here in Redding or anywhere else. I’m just saying. Look around – laziness, sloppiness and incompetence are all around us. You just can’t be too careful. Although not everyone thinks it’s necessary, I personally advocate testing six months or so after any surgery – inpatient or outpatient. It’s cheap insurance.
Many people think that Hepatitis C (HCV) is primarily a drug user’s problem. Well, it is a drug user’s problem. But if you look at the list above, you have to realize that this has broader scope than you may have thought. My husband used drugs as a young and stupid teenager. He went on to be a wonderful , responsible adult and thought he had left his “bad old days” behind. It wasn’t until his appendix blew up and, upon discharge, his surgeon mentioned that his liver enzymes were elevated that we started down this slippery slope. That surgeon saved his life being observant and diligent. We had no idea my husband had two life-threatening health conditions.
If you are regularly donating blood, your blood is being tested. If you’ve applied for life insurance, your blood has been tested. If neither of those apply, please ask your doctor to test you for hepatitis A, B & C (do not let him/her tell you you’re being silly and you don’t need to test – stand your ground on this!). Don’t let your doctor tell you not to worry about it….don’t let your doctor tell you you’re going to die – they can’t tell you either of those things based on this first test. This is simply a test to see if you have antibodies that would indicate exposure at some point. Further testing is needed to determine if you have a chronic infection.
This is truly a situation where ignorance is not bliss. What you don’t know can kill you. Remember your ABC’s and go get tested. Testing details in the next (and last) installment, then I’m done….I promise!
Hollis Pickett, in partnership with Toni Donovan, runs a Redding area non-profit – Local Area Support For Hepatitis, also known as LASH. Hollis has been involved with hepatitis advocacy since 2002 and is a steering committee member with CalHEP Alliance. She has been the bookkeeper and office manager for the law firm of Carr, Kennedy, Peterson & Frost for the past 25 years. Toni has just completed a Masters in Public Health (MPH) and is currently employed by Planned Parenthood and Acaria Health (a specialty pharmacy). LASH provides community education and patient/caregiver support for those infected with chronic viral hepatitis. A support group meets once a month for patients and their families. LASH offers group presentations, individual counseling and clinical education for patients entering treatment. You can contact them via e-mail at firstname.lastname@example.org or call Toni (945-7853) or Hollis (524-5601).