A large increase in HIV and HCV infections in Indiana among injection drug users has prompted the CDC to issue a nationwide public health alert. Here's what you can do.
A large increase in HIV and hepatitis C virus (HCV) infections in Indiana among injection drug users prompted the CDC to issue a nationwide public health alert on April 24, 2015.
"Urgent action is needed to prevent further HIV and HCV transmission in this area and to investigate and control any similar outbreaks in other communities," the CDC said in a health advisory.
A total of 142 individuals in Scott and Jackson counties have tested positive for HIV either on a confirmed or preliminary basis since last November, the Indiana State Department of Health announced. Normally, fewer than 5 HIV cases are found annually in rural Scott County.
The CDC reported that 84% of those with newly diagnosed HIV infections in these southeastern Indiana counties--a community of 4,200--also tested positive for HCV. Of 112 individuals with HIV who were interviewed, 96% had injected drugs.
"All reported dissolving and injecting tablets of the prescription-type opioid oxymorphone using shared drug preparation and injection equipment," stated the agency.
Indiana Governor Mike Pence last month reluctantly authorized a needle exchange program for Scott County so injection drug users can swap used needles for sterile ones in an attempt to limit the number of infections.
The CDC advised health departments to watch for recent rises in HCV infections, especially among individuals aged 35 years or younger, and in HIV infections attributed to injection drug use. The agency also recommended that all contacts of people with newly diagnosed HIV infections are tracked down and tested for HIV and HCV.
Recommendations for Healthcare Providers
The advisory specifically addressed what healthcare providers can do:
The advisory noted that injection drug use accounts for an estimated 8% of the approximate 50,000 annual new HIV infections in the United States. Abuse of prescription-type opioids is increasing nationally and opioid-analgesic poisoning deaths have nearly quadrupled from 1999 through 2011. Rates of acute HCV infection are increasing, especially among young, nonurban people who inject drugs, often in association with abuse of injected prescription-type opioids.
The health advisory is available on the CDC website.