Viral hepatitis C may affect thousands of Pierce County residents. National Hepatitis Awareness month calls attention to the potentially deadly infection that can cause cirrhosis or liver cancer—and how to avoid it.

“Cases of acute and chronic hepatitis C in Pierce County are on a dramatic rise, especially among young people,” said Kim Desmarais, Tacoma-Pierce County Health Department viral hepatitis coordinator. “Before 2013, we saw up to five cases a year. Now we see up to five cases a month,” Desmarais said.

In response to the increase in cases, the Health Department works with medical providers and community partners to report, test, and manage patients with hepatitis C. The Department also works to make sure these patients understand ways to stop the spread of the virus, and find treatment options for hepatitis and drug addiction. Injection drug use spreads hepatitis C.

Reports the Health Department receives of new hepatitis C cases are just the tip of the iceberg. Many with the infection may not know they have it. The Health Department estimates the new cases reported monthly in Pierce County represent fewer than 10% of the actual total. According to the Centers for Disease Control and Prevention, as many as 3.9 million Americans have hepatitis C, but only half know they’re infected. The number of people who have had hepatitis C for a long time but are just now finding out has increased because of a recommendation for doctors to routinely test people in the baby boomer generation.

Heroin and other illegal injection drug use are factors in the nationwide increase of hepatitis C cases, according to the CDC. Shared drugs and syringes spread the infection. In a 2015 survey, the University of Washington Alcohol and Drug Abuse Institute asked 77 needle exchange participants in Pierce County (referenced in the Opioid Trends for Pierce County Report) which drugs they injected. The majority (74%) said heroin, 22% said methamphetamine. When the ADAI looked at survey results from 18 needle exchange programs in the state, including Pierce County, researchers found 69% injected heroin and 22% methamphetamine.