# Presentation: 449463

## Investigation of a Cluster of Acute Hepatitis C Infectionsin IDUs, Minnesota, 2001

**Minnesota Department of Health**

## Acknowledgments

**Lynne Mercedes**
**	****Immunization, TB & International Health Section ****	****Minnesota Department of Health (MDH)**
**Tim Heymans - STD & HIV Section, MDH**
**Jessie Saavedra - STD & HIV Section, MDH**
**Jeanette Martimo**
**	****Public Health Nursing Division**
**	****St. Louis County Public Health Department**
**Carol Hooker**
**	****Epidemiology & Environmental Health**
**	****Hennepin County Community Health Department**

## We are here

**We are here**

**Minnesota**

## Background (Tim)

- April 2001 – N. MN plasma center reported HCV seroconversions in 3 young donors
- Additional cases searched in database
- Reported in previous 6 months
- Young adults (_<_ 31 yrs. of age)
- Northern MN residents

## Background (cont.)

- May 2001 – N. MN local HD contacted to follow up; results incomplete
- June 2001- DI in Greater MN asked by hepatitis surveillance staff to assist
- IDU suspected
- Hepatitis IDU cases usually unlocatable
- DIs in STD & HIV section routinely do this

## Background (Jessie)

- June 2001 – Metro local HD reported 2 acute HCV cases
- Male, Spanish-speaking (23; 33 yrs.)
- Seen in ER with Sx
- One self reported IDU initiation w/in 6 mos.
- Both roofers, per charts
- Metro Spanish-speaking DI asked by hepatitis staff to assist

## Objectives

- Locate
- Interview
- Establish risk
- I.D. partners (sex, needlesharing)
- Educate on hepatitis & STDs
- Refer for hepatitis A & B testing, vaccine
**Local HD in N. MN made tests & vaccine available**
**Hepatitis A & B tests, vaccine available in Metro area already**

## Hennepin

**Hennepin**

## Methods

- Field visits (Tim)
- Element of surprise (face to face vs. phone)
- Efficient use of travel (2-day goal)
**Day 1:  4 separate assignments**
**Day 2:  3 additional assignments & return to Duluth**
- July 2001 - (+) case fails Ix appointment; cluster Ix from partner

## Methods (cont.)

**Field visits (Jessie)**
**June 2001**
**Address noted in chart**
**Post office**
**DMV gave N. MN address**
**Bar, parked car**
**June/July 2001**
**Homeless shelter**
**Roofing company, construction sites**

## Results (Jessie)

- 2 assigned cases were confirmed acute
- SP of case #1 located; NA w/ties to Duluth
**Confirmed IDU of case**
**Admitted possible source of #1’s infection (taught him to shoot)**
**Reported case #1 moved to UT**
-  SP tested for STDs
**(+)HCV; HBV (-); started HBV vaccine**
**Other STDs (-)**
- SP named as NS partner of one of Tim’s Ix
- Case #2 homeless; unlocatable; IDU??

## Results (Tim)

- 5 of 8 assigned were confirmed acute
- 4 of 5 were Ix; SP of 5th was cluster Ix
- Of completed Ix:
- 4 acute HCV; 1 partner of acute
- 2 chronic HCV
- 1 suspected acute ruled out as (-)
** **

## Results (cont.)

- 36 additional people named (NS, SP, suspects or associates)
**6 previously reported in HCV database**
**1 new (+) moved to Oklahoma**
**20 reside on a reservation**
- Social connections between NA & Latino cases; none between whites & others
- Cases on reservation led to MDH grant to tribal health for hepatitis education, intervention, prevention activities

## Conclusion

-    Because of the overlap of risk factors for acquiring HIV, HCV, HBV, HAV & STDs, hepatitis intervention activities can be successfully integrated into existing STD & HIV programs.