Gloucester reaches out to those with hepatitis C

By Elizabeth Eddy

January 10, 2005

It's the most prevalent communicable disease in Gloucester, with more than 500 cases registered in the last 10 years. And many other people may be living with this disease without knowing it.

Spread by contact with blood, hepatitis C is a serious liver ailment that can remain undetected in the body for as long as two decades, according to Sunny Robinson, public health nurse for the Gloucester Health Department. "One of the central problems with hepatitis C is that it may leave a person without symptoms for many years, so early recognition is really important."

"Hepatitis C can remain silent for even 20 to 25 years before symptoms appear, and since many people don't know they have it, they are not making healthy choices now to protect themselves," said Susan Oleksiw, executive director of the North Shore AIDS Health Project. "Because hep C can be present in the body many years before it becomes evident, people can miss a real window of opportunity for treatment."

Reaching out to those who may unknowingly have this disease is a public health goal, Robinson said. "We want people who are at risk to recognize their risk and get tested."

Testing for the illness is a cornerstone of good health, Oleksiw added, since many people may have been exposed to this virus via blood transfusions or organ transplantation before 1992, when screening for hepatitis C was instituted. Furthermore, some who received a blood transfusion or other such product during that period were not informed of it, so they may not realize they are at risk.

Fortunately, this type of medical treatment "is no longer a source of infection in this country as these (products) are now tested for hep C," Robinson said.

The main route of infection these days, she continued, is intravenous drug use. This behavior also can spread HIV. There is also some occupational risk of contracting hepatitis C through blood exposure for those who work in the health care, military or correctional fields. Any setting where blood is present could also pose a risk, such as an unprofessional tattoo parlor or manicuring station, for example. These professions are regulated and should conform to public health standards.

Casual contact does not spread hepatitis C; it is only carried by blood. It is sometimes transmitted by sexual contact, especially if the person has multiple partners, and if any of these people are drug users.

However, people in monogamous relationships are at low risk, Robinson said.

Educating the local public about hepatitis C became easier two years ago when the Gloucester Health Department received a grant from the National Association of City and County Health Officers. The department was then able to offer an informational campaign to health and human services agencies, Robinson said.

And last year, the Health Department and the North Shore AIDS Health Project collaborated to create a one-day-a-week support program for people with hepatitis C. This program, free to participants because of grant money from Roche Pharmaceuticals, offers clients the same support model that the AIDS project developed for those with HIV and AIDS. The project also hopes to expand services with money from a new federal grant secured through the efforts of Congressman John Tierney.

The AIDS project recently expanded its holistic therapies to those with hepatitis C. The drop-in program is available Mondays from 9 a.m. to 4 p.m. Visitors can meet with a nurse educator, take advantage of case management services and advocacy, enjoy a congregate meal and, by appointment, receive holistic services such as acupuncture and massage.

"In addition, hep C-positive people offer each other lots of informal support and advice about how to live well or for dealing with treatment side effects," Robinson said. "Vaccinations against hepatitis A and B, strongly recommended for persons with hep C, are new services that will be added immediately in the new year."

The project is also considering whether to expand or change hours of service, whether to add more outreach and prevention efforts, adding testing, reinstituting a formal support group, and if the service area should be expanded, according to Robinson.

"It is a warm and caring place where you can raise concerns about any of your needs and have someone help you figure them out. Wherever you are in the continuum of treatment, the project is there to help you," Robinson said.

Caring for the mind as well as the body is an essential part of managing this illness, Robinson said. "Treatment can be arduous and difficult," she said, "so you must keep your liver healthy." This involves the "triumvirate of eating well, living healthily, and good stress management."

"The quality of food, rest, exercise and stress management are absolutely central and absolutely worthwhile for coping with hepatitis C," she continued. For example, healthy living for those with hepatitis C includes not drinking alcohol. "The use of alcohol allows hepatitis C to damage the liver more quickly."

And since the liver metabolizes all medications, hepatitis C patients "should use acetaminophen (Tylenol, etc.) in very moderate amounts. It's a very safe drug except in cases of liver damage."

For more on hepatitis C and services available to those with the illness, contact the AIDS project at (978) 283-0101 or the Gloucester Health Department at (978) 281-9771.

This article is part of a weekly educational series provided by the Gloucester Health Department and Addison Gilbert Hospital.

Copyright © 2005 Gloucester Daily Times.

This article posted January 31, 2005.