New Hampshire Public Radio's "NHPR News" last week aired a two-part series, titled "Hepatitis C: The Uncounted Disease," that examined a "building wave" of the disease that is hitting the state's health care system. NHPR requested from the New Hampshire Center for Public Policy Studies data on New Hampshire hospital discharges from 1996 to 2003. An analysis of the data found that the number of hospital visits by patients with hepatitis C increased an average of 24% annually and total hospital charges rose from less than $2 million annually to more than $17 million annually. New Hampshire is "one of only a handful of states" that does not track hepatitis C or require physicians to report newly diagnosed cases. The segment includes comments from Aydamir Alrakawi, a physician in the gastroenterology department at Dartmouth-Hitchcock Manchester; Tom Mock, director of ACORN, an HIV/AIDS counseling center in Lebanon, N.H.; New Hampshire state epidemiologist Jose Montero; and Gary Sobelson, president of the New Hampshire Medical Society (Greenberg, "NHPR News," NHPR, 11/2). A transcript of part one is available online. The complete segment is available online in Windows Media.

N.H. Outreach 'Several Years Behind' Neighboring States
The second segment in the series examined how New Hampshire remains "several years behind its regional neighbors" in its hepatitis C outreach and early detection efforts. CDC estimates that the number of hepatitis C-related deaths will triple in the next decade, primarily because of infections that occurred 20 or 30 years ago. According to national statistics, 60% of new hepatitis C cases are transmitted through injection drug use. However, most of the large increase in hospital charges for patients with the disease in New Hampshire can be attributed to residents who received a blood product or transfusion before 1992, the first year that the blood supply was tested for the virus. Other states -- including Maine, Massachusetts and Rhode Island -- have launched public information campaigns to involve health care providers in identifying residents who might not be aware they are infected, while New Hampshire public health officials have focused their outreach and early detection strategies on injection drug users, HIV/AIDS clinics and prisons. The segment includes comments from Marie Gavin, a nurse who helps run the hepatitis program at the Manchester VA Medical Center; Paul Kuehnert, director of public health emergency preparedness for Maine; Paul Loberti, chief administrator of the Office of HIV/AIDS for the Rhode Island Department of Health; Montero; and Kevin O'Conner with CDC (Greenberg, "NHPR News," NHPR, 11/3). A transcript of part two is available online. The complete segment is available online in Windows Media. The complete table of New Hampshire hospital charge trends is available online.

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