Millions unaware they have hepatitis C

The newly appointed surgeon general, David Satcher, speaks to the House subcommittee

In this story:

• Government to act on 'silent epidemic'
• Deadly disease attacks liver
• 'Aggressive timetable' for acting
• 'The blood supply is safe'
• Related stories and sites

March 5, 1998
Web posted at: 7:21 p.m. EST (0021 GMT)

WASHINGTON (CNN) -- Health officials said Thursday that millions of Americans have been unknowingly infected with hepatitis C, some of them from contaminated blood during transfusions.

"We know that many Americans infected with hepatitis C are unaware that they have the disease," said newly appointed Surgeon General Dr. David Satcher at a House Subcommittee on Human Resources hearing. "Unfortunately, many of them cannot be readily identified because the disease does not cause symptoms until it is far advanced."

CNN's Jonathan Aiken reports 1 minute, 58 second VXtreme video

Satcher pledged to track down as many people as possible who suffer from what Rep. Christopher Shays, R-Connecticut, called "a silent epidemic."

Former Surgeon General Dr. C. Everett Koop told the committee that only about 225,000 of an estimated 4.5 million infected Americans know they have the incurable and often deadly virus.

"Many with hepatitis C virus have no reason to believe they are infected," Koop said. "Many of those at high risk are average people -- middle-aged housewives who had a cesarean section delivery, young adults who had transfusions as high-risk babies or middle-aged men who served in Vietnam."

Satcher estimated that as many as 1 million Americans were infected with hepatitis C by transfusions and said, "We will aggressively pursue the people we believe have been exposed from positive donors."

"If someone had a blood transfusion previous to 1990, in particular, they need to check their blood and see if they've contracted this disease," said Shays, who is chairman of the subcommittee. "It's a kind of silent epidemic, and we need to bring it out into the open."

Deadly disease attacks liver

Hepatitis C is a potentially deadly disease that infects the liver, causing extreme fatigue, nausea, loss of appetite and abdominal pain. It can eventually cause cirrhosis of the liver and death.

It is considered a silent epidemic because many people don't develop symptoms for decades. The Centers for Disease Control and Prevention (CDC) in Atlanta estimates that 40 to 70 percent of those exposed to tainted blood become infected with hepatitis C.

Symptoms of Hepatitis C nausea and vomiting weakness fever muscle and joint pain yellowing of eyes and skin dark urine tenderness in upper abdomen

It is spread most commonly through intravenous drug use, blood transfusions and organ transplants. It can also be spread through sexual contact, although it is a less likely means of transmission.

An estimated 8,000 to 10,000 people die from hepatitis C each year.

Satcher said that those who were infected from contaminated blood transfusions could be tracked through hospital and blood bank records.

He said a government committee recommended in 1996 that these individuals be notified and that Secretary of Health and Human Services Donna Shalala has announced just such a plan. Satcher said it is his job to implement the plan.

"Within the next year we will begin this," he said, adding that the U.S. Food and Drug Administration "will issue guidance in the next few weeks to hospitals and blood banks."

'Aggressive timetable' for acting

"We have proposed an aggressive timetable for implementing these programs, and we will actively monitor their progress at the highest level of the department," he said.

Transmission of Hepatitis C comtaminated blood or blood products intravenous drug use accidental needle sticks organ transplantation kidney dialysis exchange of body fluids mother to fetus

Satcher said letters will be written to anyone who had received blood from someone who later tested positive for hepatitis C. "We will strongly urge them to come in, to be tested, to be counseled," he said.

But since many who have hepatitis C did not get it from blood donations or transfusions, Satcher said he has also directed the CDC "to ... develop educational programs for health care professionals and for the public at large to support recognition, diagnosis, counseling and testing of those at risk for hepatitis."

Satcher said, "About 85 percent of those infected develop chronic liver disease and about 10 to 20 percent eventually develop cirrhosis of the liver about 20 years after the onset of their infection," Satcher said. "Hepatitis C is the most common cause of liver failure in patients who require liver transplantation."

Although it is declining in the United States, Satcher said there are still 30,000 new cases each year. There is no vaccine for it, and no cure.

'The blood supply is safe'

Currently, interferon alfa is the recommended treatment. After a year it can cut the amount of virus in the blood to below measurable levels in 25 percent of people, and improve liver function in another 25 percent.

Letters will be sent to anyone who received blood from a donor who later tested positive for hepatitis C

The FDA has given priority status to Schering-Plough Corp.'s combination of Intron A and ribavirin, sold as Rebetol, for hepatitis C. Koop said the combination could increase the number of people whose virus can be controlled.

Shays said public concerns about hepatitis C have been overshadowed by AIDS.

"For too long it has been ... characterized as a disease confined to intravenous drug users," he added. But many people have been innocently infected through blood.

"We all know the blood supply is safe," Shays said. "It wasn't five years ago. Our guard wasn't up. We were very casual."

Reuters contributed to this report.

Related stories:

• House panel to conduct hearing on exposure to tainted blood - March 5, 1998
• Hemophiliacs warned about tainted clotting agent - January 16, 1996
• Panel warns of explosion in hepatitis C deaths - March 26, 1997

Related sites:

Note: Pages will open in a new browser window

• Centers for Disease Control and Prevention
• American Liver Foundation
• Department of Veterans Affairs
• Hep-C Alert
• The Hepatitis Foundation International
• HepNet - The Hepatitis Information Network
  • Hepatitis C InfoCenter
• A Hepatitis C Resource Page
• Pharmaceutical Information Associates, Ltd. - Managing Hepatitis C Virus Infection

External sites are not endorsed by CNN Interactive.

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