April 18, 2014 - 10:06
Hepatitis can come in unexpected ways
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Those who use someone else’s lancet and glucose meter diabetes testing devices to prick themselves to test their own blood sugar levels are at risk.
Viral hepatitis B and C, which can cause life-threatening damage to the liver, can be the unintended consequence of two recent social trends:  diabetes curiosity and self-inking/piercing. Diabetes curiosity refers to those who use someone else’s lancet and glucose meter diabetes testing devices to prick themselves to test their own blood sugar levels. Self-inkers/piercers are people who use needles or other devices to create tattoos or pierce themselves or friends. In both cases, a life-threatening hepatitis infection can spread quickly from one person to another.
“We have concerns about people borrowing someone else’s diabetes testing equipment to see what their own blood sugar levels are,” said State Epidemiologist Tim Jones, MD. “With these devices now commonplace, the testing process can generate curiosity. Parents need to know and remind children who use the devices not to share them with others, and parents of non-diabetic children should teach everyone in their family to never, ever experiment with another person’s insulin-related equipment.”
While tattoos and piercing for body adornment have been around for generations, the increased popularity of skin as a canvas for decoration causes alarm for health professionals. The primary concern isn’t tattoo/piercing studios, which are licensed and inspected, but unlicensed individuals who ink or pierce themselves or others.
“Self-inking and piercing have been common in jails and prisons for many years, and we worry some people will go that route or seek a non-licensed person to create a tattoo or piercing for them,” Jones said. “One of the main reasons we license and inspect tattoo studios is to prevent the spread of blood-borne infections such as hepatitis. Freelancers bypass the licensing process and, we’re afraid, pay little or no attention to sterilization of needles and reuse of ink vats.”
In addition to hepatitis, persons who share needles, diabetes testing equipment, insulin delivery devices and other similar items that penetrate the skin are at risk for HIV/AIDS, staph infections and other life-threatening diseases. Injectable medications marked “single dose” should never be shared, even if different syringes are used.
The two most common forms of hepatitis spread via blood and body fluids are hepatitis B and C.  With both types, the infection may destroy liver cells, cause cirrhosis and put victims at increased risk for cancer or death. Hepatitis C is now the leading cause of chronic liver disease and liver transplants in the United States.
In Tennessee, acute hepatitis B cases have increased from 236 per 100,000 people in 2007 to 300 per 100,000 in 2011. Equally disturbing is the rate of increase in acute hepatitis C cases in the same time period:  0.62 per 100,000 in 2007 to 1.31 per 100,000 in 2011.
“Diagnosis involves identifying antibodies in the blood, and then pursuing a program of treatments to control the infection,” Jones said. “Not all infections are curable, but many are manageable with proper care. Prevention is better than treatment, so ask your healthcare provider about vaccines you might need and precautions you can take to reduce your risk.”
Uninsured adults at risk for hepatitis B, including those who live with someone who has hepatitis B, can receive hepatitis B vaccine at any local health department. Contact your local health department for information. Currently, there is no vaccine to prevent hepatitis C.
Hepatitis B and C spread differently than hepatitis A, a viral infection most commonly spread by fecal matter in water and poor personal hygiene. Hepatitis A is spread by ingestion, not by blood. Hepatitis A is generally not serious, and there is no vaccine for it.    
The mission of the Tennessee Department of Health is to protect, promote and improve the health and prosperity of people in Tennessee. For more information about TDH services and programs, visit http://health.state.tn.us/.
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