SIKESTON -- Despite recent reports that the federal government fails to warn the public about hepatitis C, state health officials suggest Missourians are aware of the virus, but aren't completely educated about it.
"Awareness is happening -- whether the public actually understands the disease, I don't know -- but people have heard of it," said registered nurse Roberta Renicker, who works for the communicable disease prevention section of Missouri Department of Health and Senior Services.
In 1997 hepatitis C, a disease of the liver caused by the hepatitis C virus (HCV), became a reportable communicable disease in Missouri, Renicker recalled. Legislation was passed by the late Gov. Mel Carnahan in 1999 to educate citizens of Missouri about hepatitis C, and since then Renicker has been one of those educators.
"From the time I started in 1999 educating and doing programs on hepatitis C, I've noticed a difference in awareness of the virus," Renicker said. "When I started, lots of people were saying they'd never heard of this, and now at least people say they've heard about it or read about it."
Renicker pointed out many people are confused by all of five types of the virus -- A, B, C, D and E.
The Kansas City Star reported Sunday that nearly every public education campaign about the virus has sputtered, with the government often citing a lack of money as the reason.
While this may be true, lack of funding isn't unique to Missouri, Renicker noted, adding the state always needs more dollars whether for hepatitis education or something else.
Autumn Grim, communicable disease coordinator for the Southeastern District Missouri Health Office in Poplar Bluff, said currently they have no funding in place dedicated solely to hepatitis C prevention or care in this region.
In the past couple of years, there have been classes provided to local health departments by the state's hepatitis C coordinator. Grim estimated at least five such educational opportunities on the basic epidemiology of hepatitis C have occurred in this region, however, there is no longer a hepatitis C coordinator in Missouri.
Due to budget cuts within in the last year, Renicker said her role as a public educator has also changed. She now focuses on educating professionals such as physicians and nurses, and they, in turn, get the information to their citizens in their particular communities.
The Centers for Disease Control and Prevention, in an estimate that has not changed in a decade, says 8,000 to 10,000 people die each year of hepatitis C. A National Institutes of Health conference in 2002 put the death toll at 10,000 to 12,000, but said that might be a low estimate.
The CDC estimates the total number of HCV infections is at 3.9 million, although some researchers think it is higher. "The problem with hepatitis C is it's a silent epidemic so we really don't know how many people are infected with the disease," Renicker said.
Lots of people go undiagnosed and it's called a silent disease because a lot of people don't have symptoms, Renicker said. A person can have it for say 20 years and not know they're sick," she pointed out.
The number of cases doubled each year from 1999-2001. Then in 2002, health officials saw a decrease in the amount of reportable cases, Renicker said.
"We saw a big increase right after Sept. 11 in the terrorist attacks. The most interesting thing about that was when people went to donate blood, they were finding out they had hepatitis C.
She continued: "They were very lucky people. Even though they may have been turned down to donate, they were very fortunate that they were diagnosed with hepatitis C. So something good did come out of Sept. 11 for a number of people -- it even trickled all the way down to Missouri."
A simple blood test can detect hepatitis C. Many people are finding out they have the virus because some doctors are jumping on the bandwagon and testing for the disease during annual patient physicals, Renicker said. Others are going into the doctor after they've heard about it and getting tested, she explained.
Education of the hepatitis C disease and virus needs to continue, Renicker insisted. Health officials are beginning to target the younger people, she said.
"We see the Vietnam-era veteran has a high incidence of hepatitis C, which is the 50-60-year-old person, but the younger generations are just now seeing it because of tattoos and body piercing," Renicker said.
Self-piercings and self-tattoos are getting out of control, Renicker commented. Kids and parents don't realize the risks involved if they don't go to a reputable tattoo parlor practicing sterile techniques, she said.
Renicker recalled: "School nurses, teachers and principals would call me and tell me they've got students piercing themselves in the school bathrooms and that the students were having after school tattoo parties."
As a result another big insurgence of the virus is expected to take place in the next 15-20 years.
The Associated Press also contributed some information for this story.