July 2, 2019

Karen Gorby: Understanding Hepatitis: On the Rise in Western North Carolina

By Karen Gorby
Chief Executive Officer/Chief Nursing Officer, Angel Medical Center

Karen Gorby, Angel Medical Center President/CNO

July is a good month to talk about hepatitis, as July 28 is World Hepatitis Day. The hepatitis viruses that are affecting the most people locally are hepatitis A, B and C. The hepatitis virus causes inflammation of the liver, and though people can feel or show symptoms, many don’t. Out of the more than 4 million Americans living with hepatitis, most are unaware that they have it. Chronic forms of hepatitis can cause liver swelling and raise one’s risk of liver cancer.

Unfortunately, there has been an increase of hepatitis in Western North Carolina. This column will focus on who’s at risk for hepatitis, how to treat it and how to prevent it.

Hepatitis A is easily spread through direct or indirect contact with fecal matter, either from a person who has not practiced good handwashing or by touching a raw product that’s contaminated. A person who catches it could have eaten food prepared by a contaminated person, simply been in close proximity to them or have had sexual contact with them. Symptoms can be flu-like or nonexistent. Hepatitis A usually clears up on its own within a period of weeks.

We’ve seen a resurgence of hepatitis A in Western North Carolina, and Ohio is currently experiencing a hepatitis A crisis. You can protect yourself from Hepatitis A by practicing good handwashing and by washing your raw fruits and vegetables well.

Between 2012 and 2016, hepatitis C rates went up by 200 percent across the state and hepatitis B rates climbed by 62 percent, and the numbers have continued to climb. Hepatitis B and C rates have increased just as alarmingly in western North Carolina.

Both types are spread through a person’s contact with another person’s bodily fluids, whether that’s sexual activity or IV drug use. Sharing things that come into contact with blood, like razors, or getting tattooed or pierced with instruments that aren’t sterile also raise the risk of contracting hepatitis B and C.

The opioid crisis has devastated our region and is the biggest contributor to high rates of both of these types of hepatitis. Needle sharing between people misusing opioid painkillers is the biggest reason for the expanded case numbers, but heroin use is another factor.

The teen/young adult population in our region has also seen a huge spike in hepatitis C cases, and these are traced to unsterile tattooing practices. A tattoo parlor’s cleanliness should rival that of a doctor’s office – the tattoo artist should wear gloves, a new needle should be used for each tattoo and all equipment should be properly sterilized. “Stick and poke” tattoos are also popular with teens. These “DIY” tattoos are done with a needle and ink that is bought online and are unlikely to be sterile.

In early May, the FDA announced a recall of six different tattoo inks. These particular inks contain bacteria that can cause infection or lesions if used. The following inks are affected: Scalpaink, SC; PA; AL (all shades of black), Dynamic Color (also black), Solid Ink-Diablo (red). If considering a tattoo, please ask the artist what ink they use prior to receiving one.

Luckily, vaccinations exist to prevent hepatitis A, which is only given to those who travel outside the United States to certain countries where the disease is a concern, and hepatitis B. Any family with a student headed to college, for example, should get them vaccinated for hepatitis B, which is easily accessible. Unfortunately, there is no vaccine for hepatitis C at this time. The other key preventive strategy is not engaging in needle sharing if you’re using intravenous drugs. For those diagnosed with hepatitis B and C, long-term antiviral medications and a medication called interferon are used.

Hepatitis in all its forms poses a very real threat to our public health. We at Angel Medical Center are primary care providers and as such, consider it our job not only to treat the public, but to provide education about urgent health issues like this that affect our communities.

On another note, we are excited to be in the planning stages for the new hospital here in Franklin. The sign is up at One Center Court, and we are in the process of obtaining permits. I look forward to sharing all the details as they solidify.


Angel Medical Center

Karen S. Gorby, RN, MSN, MBA, CENP, FACHE, is Chief Executive Officer and Chief Nursing Officer of Angel Medical Center. Gorby is a Fellow of the American College of Healthcare Executives (ACHE). For nearly three decades, she has served hospitals and health systems in Ohio before assuming her role at Angel Medical Center. Gorby received her MSN from Saint Joseph’s College in Standish, Maine, and her MBA from Wright State University in Fairborn, Ohio.