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Indiana HIV outbreak, hepatitis C epidemic sparks CDC alert

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By JENI O'MALLEY 
Associated Press
    An Indiana county is experiencing nearly daily increases in new HIV infections tied to intravenous drug use, and health officials hope the situation prompts other states to closely track their hepatitis C and HIV rates to identify potential clusters of the diseases.
    Indiana state health officials said Friday that the number of positive HIV tests so far this year has jumped to 142 in Scott County, which saw just three new HIV cases between 2009 and 2013, and has never seen more than five cases in a year, health officials said.
    The new number includes 136 confirmed cases and 6 preliminary positives in the county, about 30 miles north of Louisville, Kentucky.
    "We literally have new cases being reported every day," said Dr. Jerome Adams, the state's health commissioner.
    Dr. Joan Duwve, chief medical consultant for the Indiana State Department of Health, said four out of five people infected in the outbreak have acknowledged using injectable drugs, mostly the painkiller Opana.
    Federal health officials helping to contain the outbreak issued an alert to health departments nationwide on Friday, urging them to take steps to identify and track HIV and hepatitis C cases in an effort to prevent similar outbreaks elsewhere.


    The CDC recorded a 150 percent increase in acute hepatitis C cases from 2010 to 2013, said Dr. Jonathan Mermin, director of the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. Health officials say high rates of hepatitis C are a key indicator of needle-sharing and a potential HIV outbreak.
    "The situation in Indiana should serve as a warning that we cannot let down our guard against these deadly infections," Mermin said.
    The advisory urges health departments to review recent data on HIV and hepatitis C diagnoses, overdose deaths, drug arrests and admissions for drug treatment to identify communities at risk for unrecognized clusters of HIV and hepatitis C infections.
    Hepatitis C, which is most commonly spread through the sharing of drug needles, can lead to liver cancer and and is the leading reason for liver transplants. The virus also can trigger damage in other parts of the body, though it can take decades for symptoms to emerge. HIV spreads among drug users mainly through unprotected sex and the sharing of needles.
    Indiana typically sees about 500 new HIV cases a year, health officials have said. The Scott County outbreak is just the "tip of the iceberg" of a national opiate abuse problem that puts people at high risk of infectious diseases, Mermin said.
    Adams said the state has spent more than $2 million on efforts to fight the outbreak, which include testing, awareness campaigns, a limited needle-exchange program and an outreach center that allows people to sign up for health insurance and other services.

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