The Centers for Disease Control and Prevention (CDC) on Friday issued an urgent warning to health officials across the country about the HIV outbreak in a rural Indiana county, which has now infected 142 people.
The CDC’s health alert advises health departments and healthcare providers on how to control HIV and hepatitis C outbreaks among injection drug users.
Officials from the CDC and the Indiana Department of Health said they are increasingly alarmed by the outbreak of HIV and hepatitis C in Scott County, Ind., which they said is rare in the rural United States.
“This is the first outbreak of its type that we have seen documented in recent years,” Dr. Jonathan Mermin, who leads the CDC’s HIV prevention center, told reporters Friday.
The vast majority of infected people are injection drug users, including those on methamphetamine and heroin, which Mermin said could be a harbinger of more outbreaks in similarly impoverished communities.
“This outbreak that we’re seeing in Indiana is really a tip of an iceberg of a drug-abuse problem that we see in the United States,” he added.
Nearly 9 in 10 people who tested positive for HIV have also been diagnosed with hepatitis C, according to a CDC report released Friday.
The outbreak has spanned ages 18 to 57 years old, though the median age is 32 years old. A “small number” of pregnant women have also been diagnosed.
Gov. Mike Pence, a Republican, formally declared a state of emergency on March 26, which gave the governor’s office the power to temporarily authorize a needle exchange.
Pence has argued that needle exchanges should not become permanent public policy, though state legislators are currently debating the issue.
State Health Commissioner Dr. Jerome Adams on Friday stressed that needle exchanges were an “extreme measure” to quickly halt the outbreak.
“A lot of people have been overstating needle exchange in terms of its independent ability to stop drug use,” he said. “Needle exchange alone is not a panacea.”
Nearly all of the infections have occurred in Scott County, where poverty, unemployment and teen pregnancy are among the highest in the state. The county of about 24,000 also ranks among the lowest in the state for life expectancy and general health.
Dr. Joan Duwve, the chief medical consultant for Indiana’s state health department, said prescription drug abuse has also been escalating in Scott County for at least a decade. She said there are “few resources” and “not a lot to do” in the county, which has fueled the behavior among people of all ages.
“There are children and parents and grandchildren who use in the same house and are injecting drugs together as sort of a community activity,” Duwve said Friday.