Hepatitis C (new cases)
Published: 06.10.05 Updated: 06.10.2005 11:33:26
Hans Blystad, Lars Blad, Johan Giesecke, Swedish Institute for Infectious Disease Control, Sweden, the Steering Group of the project Building a Network for Infections Disease Surveillance in the Baltic Sea Region
Hepatitis C is a chronic disease that is rarely symptomatic in the acute stage. It is therefore a disease that is difficult to monitor, particularly its incidence.
Hepatitis C surveillance and reporting varies within the region. Most countries only report acute cases, while Sweden and Iceland reports all anti-HCV positive cases without differentiating between acute or chronic carriers. Finland reports both acute cases and carriers. As most acute cases of hepatitis C are asymptomatic, the reported incidence of acute hepatitis C probably does not reflect the true incidence of the disease.
Ever since hepatitis C serology was introduced in the late 1980s, an increasing number of anti-HCV positive cases have been diagnosed all over the region. In the Nordic countries and Germany, many of these have been diagnosed in older age groups who were infected while injecting drugs in the 1970s and 1980s. In the eastern part of the region most cases are diagnosed among young, active drug users.
Intravenous drug users represent by far the highest risk group for hepatitis C in the region. Studies in the Nordic countries have shown that 50-80% of intravenous drug users are anti-HCV positive. The extent of nosocomial transmission of hepatitis C is mostly unknown.
The main measures to reduce the incidence of hepatitis C are to reduce intravenous drug abuse and implementing harm reduction by ensuring clean needles and syringes for the drug users. These are available at pharmacies in the region. In addition, local health authorities in the region, except for Iceland and Sweden, have introduced extensive free needle programmes, needle exchange programmes or both. An effective hospital infection control is considered important to prevent nosocomial infections and is of particular importance in the eastern part of the region.