Madison County Health Department gives HIV and Hepatitis C screenings at the Veterans Stand Down event Friday. Staff photo by John P. Cleary

Madison County Health Department gives HIV and Hepatitis C screenings at the Veterans Stand Down event Friday. Staff photo by John P. Cleary

ANDERSON — Five years ago, the number of reported cases of acute hepatitis C in Madison County was so low, local health officials didn't have to report the results to the Indiana State Department of Health.

But the emerging — and still growing — opioid crisis, accompanied by young people injecting drugs, has changed all that.

Nationally, from 2010 through 2016, the number of reported cases of hepatitis C increased from 850 to 2,967, according to the Centers for Disease Control and Prevention

By 2017, Madison County ranked second in the state for new reported cases of hepatitis C, said Rebecca Sanders, infectious disease coordinator for the Madison County Health Department.

"The increase in acute HCV case reports reflects new infections associated with rising rates of injection-drug use, and, to a lesser extent, improved case detection," the CDC said in a recent report. "Several early investigations of newly acquired HCV infections reveal that most occur among young, white persons who inject drugs and live in non-urban areas."

In layman's terms, that means young people are sharing dirty needles to shoot up heroin and other illegal drugs, which is how the disease is transmitted from person to person. Because they fear arrest for revealing their drug use, the actual number of new hepatitis C cases is far higher — 13.9 times higher, according to CDC calculations.

By that measure, the number hepatitis C cases reported in 2016 may actually be an estimated 41,200, and the 10 new cases reported in Madison County in 2017, may be closer to 140.

"All it takes is one person to infect an entire network of people," said Sanders, who directs a staff of employees who try and locate intravenous drug users and anyone they may have shared a needle with. 

For Madison County Sheriff Scott Mellinger, who raised the issue of increased hepatitis C cases and AIDS and HIV cases at a meeting of the Madison County Mental Health Coalition, an effective set of county programs in response to the drug epidemic can't come soon enough.

He estimates at least 80 percent of inmates housed at the Madison County Jail — the majority of whom have not yet been convicted of any crime yet — have been arrested on drug-related charges.

County taxpayers, he said on Friday, are the ones paying the cost of housing inmates and treating health issues related to drug use.

"We still haven't made a dent in the number of people who use drugs," in Madison County, he said.

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