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Indiana HIV outbreak, hepatitis C epidemic sparks CDC alert

Rural Scott County, Indiana is seeing an increase in the number of people with HIV infections on a daily basis, just about all of them tied to intravenous drug use. The situation is so bad it has prompted health officials to alert other states so they can track HIV and Hepatitis C infections, looking for another possible cluster or outbreak.

Indiana state health officials said on Friday the number of positive HIV tests has jumped to 142 in Scott County alone. Between 2009 and 2013, there were just three cases recorded in the county.

Indiana Governor Mike Pence earlier this month declared a public health emergency in Scott County. The HIV outbreak began in December 2014 and is centered in Austin, a city of 4,300 people about 30 miles north of Louisville, Kentucky.

The governor recently extended his executive order to include temporary creation of a needle-exchange program, which is illegal under state law, in Scott County. The order now extends through May 24.

“We literally have new cases being reported every day,” said Dr. Jerome Adams, the state’s health commissioner. Dr. Joan Duwve, chief medical consultant for Indiana’s State Department of Health says at least four out of five infected people admitted to using intravenous drugs, mostly the painkiller Opana.

Opana is oxymorphone, an opioid pain medication used to treat moderate to severe pain. Since 2012, Opana has been the drug of choice for abusers, replacing methamphetamines, according to local authorities.

Before 2011 in Scott County, the number of deaths from intravenous drug overdose was about 20 percent of all deaths. By 2012, deaths from intravenous drug use accounted for 50 percent of all deaths, and the numbers just keep rising.

Police officials say the change over to Opana came after OxyContin was changed in 2010, making it more difficult to snort or inject to get a high. Opana is called “stop signs,” “the O bomb,” and “new blues” on the street, and is crushed and either snorted or injected. Crushing does away with the timed-release way the pill is designed to work, releasing the drug all at once.

The CDC said in today’s advisory that the number of cases of Hepatitis C is on the increase across the country, directly proportional to increased intravenous drug use. The number of cases of the blood-borne infectious disease has increased 150 percent between 2010 and 2013. Fully 70 percent of intravenous drug users are infected with hepatitis C.

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