West Virginia is facing 'most concerning' HIV outbreak, here's the truth behind reports from Kanawha County
Additional HIV cases seem to be from 'injecting drug use is the primary risk factor and many of them of homeless'
West Virginia's Kanawha County is seeing a huge jump in the number of HIV cases, pushing the Kanawha-Charleston Health Department to initiate a series of mobile HIV testing clinics.
According to the Kanawha County Commission, the county has had the "most concerning" HIV outbreak in the country. The Commission submitted letters to Senator Joe Manchin and Senator Shelly Moore seeking to open a congressional inquiry with the Centers for Disease Control (CDC) to investigate the matter. Following which on Monday, April 5, Manchin submitted the inquiry with CDC.
In a letter to the CDC director Dr Rochelle Walensky, Manchin asked that the CDC review the commission's concerns and reply by April 9. Commission President Kent Carper reportedly said that the outbreak is "an important public health issue and is deserving of our full understanding.”
'Tip of the iceberg'
Dr Demetre Daskalakis, the CDC’s chief of HIV prevention, in early February, gave a presentation at a meeting of a Kanawha County HIV task force. "It is possible the current case count represents the tip of the iceberg. There are likely many more undiagnosed cases in the community. We are concerned that transmission is ongoing and that the number of people with HIV will continue to increase unless urgent action is taken."
The truth inside the matter
“When you hear 50 HIV cases, they may not sound like a lot, but when you’re seeing that number in a population that historically you may see less than five, that is concerning when it’s above baseline,” Christine Teague, CAMC’s Ryan White Program Director said.
According to the latest reports, the commission's letter to Manchin asked whether the CDC had completed an official investigation into the county's HIV surge. Teague reportedly said that the additional HIV cases seem to be from "injecting drug use is the primary risk factor and many of them of homeless."
Data from the state health departments reveal that as of 2014, 12.5% of the HIV cases in West Virginia were the result of intravenous drug use. However, this number increased to a shocking 64.2% by 2019. This increase has been reportedly attributed to clusters in Kanawha and Cabell counties.
According to the latest reports, Kanawha County, which includes Charleston and has 178,000 residents, had two intravenous drug-related HIV cases in 2018. The number grew to 15 in 2019 and at least 35 last year, Shannon McBee, a state epidemiologist, revealed. According to the CDC, in comparison to the county, New York City, which has a population of more than 8 million, recorded 36 HIV cases related to intravenous drug use in 2019. Daskalakis revealed that counties in other states with populations similar to Kanawha had an average of less than one HIV diagnosis among people who inject drugs.
The surge is clustered around the capital of Charleston and the city of Huntington. Reports reveal that it is being attributed to the 2018 cancellation of a needle exchange program that offered clean syringes to injection drug users not able to quit the habit altogether, at least in part. Although needle exchange programs exist in dozens of states — as it is included in the CDC's recommendations for controlling disease outbreaks among intravenous drug users — it is reported that critics say authorities don't do enough to prevent or stop drug abuse in West Virginia.
Dr Sherri Young with the Kanawha-Charleston Health Department reportedly said that some part of the spike may be attributed to more people going to the hospital for treatment. “What that tells us is that we’re missing something. If they come to the hospital to be tested for HIV or because of a complication from HIV, then we need to connect to them to get treatment before they become inpatient,” Dr Young said.