The reason: rampant intravenous drug use and unprotected sex among people in poverty-stricken areas of the region known as Appalachia.
Doctors aren't as concerned about the hepatitis C as they are about what it foreshadows. Dr. Jennifer Havens, an epidemiologist at the University of Kentucky's Center on Drug and Alcohol Research, told the Associated Press that an outbreak of the illness usually precedes a breakout of HIV.
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"One person could be Typhoid Mary of HIV," Havens told the AP.
Hepatitis C and HIV were largely considered to be an "urban" problem, but now the widest breakouts of cases are centered in rural areas of the country faced with high poverty and drug use. One such place, Scott County, Indiana, had 160 people diagnosed with HIV in six months, compared to only 49 cases diagnosed in New York City in all of 2013, according to the AP report.
The answer for many states is creating needle exchange programs to discourage drug users from reusing or sharing needles with others.
"We have to change the way we think, we have to open our minds and think of other options and, yes, that includes needle exchanges," said Sue Yates, a drug court program director for 20 counties in Kentucky that attempt to divert addicts into treatment rather than jail. "It's better than doing nothing, which is what we're doing now."
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Some people — both addicts and medical professionals — say that needle explosions do little more than encourage people to use. However, nurse practioner and addict Tammy Brooks said that access to clean needles is what saved her from getting hepatitis C like many of her fellow drug users.
"You're not even human," she told the AP of her drug use. "All your head is saying is to use, use, use."
"If you knew your child was going to get in the neighbor's pool, wouldn't you want them to know how to swim?" she added of the need for exchange programs. "You wouldn't just say 'don't get in the pool.' Cause you know they will anyway."
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