CN continues screening, curing hepatitis C
Jorge Mera, Cherokee Nation’s director of infectious diseases, accepts an award at the White House in May 2016 for the tribe’s hepatitis C elimination project. COURTESY
Dr. Jorge Mera, Cherokee Nation’s director of infectious diseases, talks to a patient at W.W Hastings Hospital in Tahlequah, Oklahoma. Mera is leading the tribe’s charge to test citizens for hepatitis C and treat those who have the disease. WILL CHAVEZ/CHEROKEE PHOENIX
TAHLEQUAH, Okla. – In 2015, the Cherokee Nation became the first tribe to launch an elimination project with the U.S. Centers for Disease Control and Prevention to screen and treat tribal citizens for hepatitis C.
And since the project’s inception, more than 40,000 people have been screen.
CN officials proclaimed Oct. 30 as Hepatitis C Awareness Day and said the tribe continues its efforts to reach it goal of screening 80,000 patients.
“Hepatitis C is a virus that affects primarily the liver but it can affect other organs, too. It was isolated in 1989, although we knew it existed long before that time,” Dr. Jorge Mera, CN director of infectious disease, said.
Hepatitis C was identified as non-A or non-B hepatitis before it was labeled as a third virus.
Symptoms are not present unless it has not been identified or treated for a period of time and cirrhosis of the liver sets in.
“The symptoms are basically symptoms of cirrhosis. So anything that inflames the liver for many years may end up causing a lot of scarring of that liver and when the scarring is sever enough we label it as cirrhosis,” Mera said.
The virus can be contracted several ways. Mera said in approximately 90 percent of cases, people who inject drugs and share needles, syringes or paraphernalia, contract it.
In the past, blood transfusions played an important role in contracting the virus until 1992 when blood banks began checking for it. Tattooing in a non-professional parlor can also play a role.
There is also a small chance, roughly 5 percent, that a mother can transmit the disease to her newborn child, Mera said.
He said there are ideal and practical ways to prevent the disease from spreading.
“Ideal would be that people would not use illegal drugs and not inject them. We know that we can mitigate that but we will never reach zero on that. That’s a reality. People have been using illegal drugs for millenniums, and it’s not going away soon,” Mera said.
He said if people use drugs they should use clean needles and syringes each time they inject and to not share needles with anyone. He added that there is a need for needle and syringe exchange services, which is illegal in Oklahoma.
Other tribes and places in the United States, such as New York City and San Francisco, are creating their own hepatitis C elimination programs.
“Now the advantage they have over us is that they have needle and syringe services. It’s going to be very difficult to eliminate hep C if you don’t have needle and syringe services because there will be a point that people will continue to transmit, and I can only go and catch them and treat them. But I would like to cut that transmission,” Mera said.
To prevent the disease’s consequences once it is contracted is for people ages 20 to 72 years old to get screened.
“We offer free screenings and free treatments at W.W. Hastings Hospital in Tahlequah, Oklahoma,” Mera said. “In Cherokee Nation, 3.4 percent of Cherokees ages 20 to 72 are positive for hepatitis C. In other Native American communities there have been reported rates as high as 8 percent and also lower rates.”
He said hepatitis C is the top “killer of blood-born pathogens” than any other reportable disease of the CDC and has killed more than the rest of the reportable diseases combined.
“Hepatitis C mortality is greater in Native Americans in general than non-Native American populations in the United States,” Mera said.
Mera said the screening process is simple and all one has to do is request a screening in the Urgent Care or with their providers at W.W. Hastings Hospital. The screening contains a blood drop, in which results are ready in 24 hours.
He said treatment options, depending on the severity of the virus, is taking a pill regiment for eight to 12 weeks, in which 95 percent cure rates have been seen. “It’s the only chronic infectious disease that you can cure and, to my knowledge, is the only chronic disease you can cure. Because you can’t cure diabetes or high blood pressure, those you have to treat for life, or HIV for that matter. But this is eight to 12 weeks and you’re done.”
He said though the treatment is simple the hard part is getting people to get tested.
Roughly 50 percent of the population of the 85 percent goal has been screened. Approximately 78 percent have tested positive and more than 90 percent have been cured of the virus.
“On cure rates we’re meeting our goal. On screening we still have a ways to go. And in engagement of care there’s still room for improvement,” Mera said. “I would really like to eliminate hepatitis C from Cherokee Nation. That would be my goal.”