The life you save . . .

I’m finding the New York Times to be a good source of public health information – usually with an interesting personal angle. I would recommend a recent story by Dr. Pauline Chen, entitled From Needle Stick to Cure for Hepatitis.

Within this relatively short question and answer piece, Dr. Chen offers insight into the occupational hazards of medicine, provides a brief history and clinical overview of hepatitis C, and chronicles the inspiring story of Dr. Douglas Dieterich – a physician infected for many years with hepatitis C (known as non-A, non-B hepatitis at the time of his exposure).

In brief, Dr. Dieterich’s story is a testament to courage, persistence and altruism. But go ahead and read the story. I would only add one comment that his recurrent symptoms of jaundice and fever are a bit atypical. Most individuals do not experience any symptoms due to hepatitis C infection, and often get sick only after it is too late for effective treatment. Early screening and detection is therefore a key to addressing hepatitis C.

As stated previously, APCA has recently been awarded a grant to conduct hepatitis C screening and education. It’s humbling to know that our screening program leverages the fact that effective treatment now exists for hepatitis C – through some of the very research conducted by Dr. Dieterich himself. Many, many people owe a debt of gratitude to Dr. Dieterich for his persistence and his optimism, as he states it: “I think it’s the beginning of the end of hepatitis C, and this is one of the happiest statements I can make.”

- Doug Hirano, MPH, APCA Executive Director

Good News About Hepatitis C

I’m happy to report that APCA has received notice that it will be receiving a grant from Vertex Pharmaceuticals to conduct hepatitis C screening and education. According to the CDC, hepatitis C is “the most common chronic bloodborne infection in the United States; an estimated 3.2 million persons are chronically infected.”

Receipt of this new grant award is good news on two fronts. First, we can always use some additional financial support in these difficult economic times, and second and more importantly, identifying individuals chronically infected with the hepatitis C virus is now more important than ever – given the recent progress in treating this infection. With the advent of new hepatitis C therapies, up to 80% of infected individuals can have the virus cleared from their bloodstream indefinitely (known as “sustained virologic response”). This is essentially curing the disease.

However, like chronic hepatitis B infection, infection with the hepatitis C virus (HCV) is very often asymptomatic, and most infected individuals are unaware that they carry the virus. Finding out one’s infection status through a simple blood test is therefore critically important and can provide an HCV-infected individual a very good chance of avoiding the severe liver disease (e.g., cirrhosis and liver cancer) often association with infection.

Consequently, we are pleased to be able to initiate a hepatitis C public education and screening program targeting local Asian Americans and Pacific Islanders through this new grant program and thank Vertex Pharmaceuticals for its support.

- Doug Hirano, MPH, APCA Executive Director

Of Viruses and Cancer

I came across an interesting story in New York Times yesterday. The story, “Human Papillomavirus, 1985,” describes Dr. Peyton Rous’ conjecture and eventual demonstration that viruses can cause cancer. He demonstrated this fact through his work with solid tumors in chickens back in 1914.

Seventy years later, scientists would still be trying to prove that viruses cause cancer in humans. In 1983, Dr. Harald zur Hausen, definitively connected infection with the human papillomavirus (HPV) with cervical cancer. Indeed, he discovered and made HPV16 and 18, the two strains most commonly associated with cervical cancer, available to the scientific community for vaccine development. More than two decades later (2006), a vaccine for HPV infection was approved for use in girls and young women ages 9 to 26 years of age. Given that 5% of all cancers worldwide are caused by HPV, the development and widespread use of the vaccine will eventually save tens of thousands of lives every year.

While most of us have never heard of Drs. Rous and zur Hausen, we clearly owe them a debt of gratitude. I’m happy to say that both received the Nobel Prize for their work.

Particularly among Vietnamese American women, cervical cancer rates are disproportionately high. In fact, rates of cervical cancer are several-fold higher among Vietnamese women, when compared to all other racial/ethnic groups. Efforts to educate and vaccinate the Vietnamese and other Asian American and Pacific Islander communities are warranted.

Interestingly, the article did not mention the other virus that causes cancer in humans: the hepatitis B virus (HBV). HBV infection is conclusively linked with liver cancer. Given the disproportionately high rates of HBV infection among Asian Americans, it is not surprising that liver cancer rates are much higher for Asian Americans, when compared to non-Hispanic whites. The 1982 development of a vaccine to prevent hepatitis B infection by Dr. Baruch Blumberg is another milestone in the history of cancer prevention, but perhaps that is a story for another time.

- Doug Hirano, MPH, APCA Executive Director

A Death in the APCA Family

It is with extreme sadness that I report the death of Ms. Shwuing Fu, publisher of the Asian American Times. She died this past weekend in a car accident. She was a good friend to APCA – generously finding space in her newspaper to report on our events and activities and donating fine art to our fundraiser silent auctions. She worked tirelessly to report community news throughout the various Asian American and Pacific Islander communities. She was both a good friend and good colleague. She will be sorely missed, but not forgotten.

- Doug Hirano, MPH, APCA Executive Director

World Hepatitis Day Proclamation

WORLD HEPATITIS DAY, 2011

BY THE PRESIDENT OF THE UNITED STATES OF AMERICA

A PROCLAMATION

Across our Nation, millions of Americans are living with viral hepatitis. As many as three-fourths of Americans living with the disease are unaware of their status and are not receiving care and treatment for their condition. Raising awareness about hepatitis is crucial to effectively fight stigmas, stem the tide of new infections, and ensure treatment reaches those who need it.

On World Hepatitis Day, we join with people across our country and around the globe in promoting strategies that will help save lives and prevent the spread of viral hepatitis.

Viral hepatitis is inflammation of the liver, and can cause a lifetime of health issues for people who contract it. Hepatitis B and C viruses are the cause of a growing number of new liver cancer cases and liver transplants. In the United States, hepatitis is a leading infectious cause of death, claiming the lives of thousands of Americans each year. While we have come far, work still needs to be done to prevent and treat this disease.

Viral hepatitis touches Americans of all backgrounds, but certain groups are at greater risk than others. Past recipients of donated blood, infants born to mothers infected with viral hepatitis, and persons with sexually transmitted diseases or behaviors such as injection-drug use have risks for viral hepatitis. Baby boomers and African Americans have higher rates than others of contracting hepatitis C. Half of all Americans living with hepatitis B today are of Asian American and Pacific Islander descent, and one-third of people living with HIV also have either hepatitis B or hepatitis C. Worldwide, one in twelve people is living with viral hepatitis.

We must make sure that this "silent epidemic" does not go unnoticed by health professionals or by communities across our country. Under the Affordable Care Act, services including hepatitis immunizations for adults and hepatitis screenings for pregnant women are fully covered by all new insurance plans. My Administration has also released a comprehensive Action Plan for the Prevention, Care and Treatment of Viral Hepatitis. The plan brings together expertise and tools across government to coordinate our fight against this deadly disease. Our goal is to reduce the number of new infections, increase status awareness among people with hepatitis, and eliminate the transmission of hepatitis B from mothers to their children.

The first step toward achieving these goals is raising public awareness of this life-threatening disease. We must work to reduce the stigma surrounding hepatitis, and to ensure that testing, information, counseling, and treatment are available to all who need it. The hard work and dedication of health-care professionals, researchers, and advocates will help bring us closer to this goal. On this day, we renew our support for those living with hepatitis, and for their families, friends, and communities who are working to create a brighter, healthier future.

NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim July 28, 2011, as World Hepatitis Day. I encourage citizens, Government agencies, nonprofit organizations, and communities across the Nation to join in activities that will increase awareness about hepatitis and what we can do to prevent it.

IN WITNESS WHEREOF, I have hereunto set my hand this twenty-seventh day of July, in the year of our Lord two thousand eleven, and of the Independence of the United States of America the two hundred and thirty-sixth.

BARACK OBAMA

- Doug Hirano, MPH, APCA Executive Director

What’s the big idea?

The Center for the Future of Arizona is looking for “big ideas”. In early April 2011, the Center invited communities across the state to develop proposals that describe how they could improve civic health in Arizona. The reason for this call for proposals was quite simple: Arizona ranks very low on virtually all indicators used to measure civic health. Here’s a sample of the available data:

• Arizona ranks 40th in the nation for voter registration and 43rd for voter turnout among eligible citizens.
  


• 37% of Arizonans say they do not follow the news or discuss the news regularly.
  


• Arizona ranks 48th in the nation for exchanging favors with neighbors regularly and 45th for eating dinner with family/household members almost every day.

In addition, a Gallup Poll found that only 10 percent of Arizonans believe that elected officials represent their interests, and only 10 percent rate the performance of elected officials as “very good.” Other areas of concern included quality jobs for all Arizonans, a competitive P-20 education system and a healthy environment – each of which cannot be achieved without the sense of connection that Arizonans feel to one another.


This project, known as the “Five Communities Project,” is looking for big ideas to address the state of civic health and engagement in Arizona. The Center received 96 letters of intent in response to its April call for proposals – one of which was submitted by APCA. Happily, APCA is one of 33 organizations to be named as a semi-finalist in this competition.


Ultimately, there will be just five communities selected to partner with the Center in developing a collaborative proposal that will be submitted to some of the nation’s most esteemed and influential foundations. The objective is to provide partner communities with the resources to implement their plans over a three-year funding period.

What is our “big idea”? Suffice it to say that we’re envisioning a more cohesive and engaged Asian American and Pacific Islander community in the greater Phoenix metropolitan area. I’ll provide greater detail on our “Thirdspace” initiative in a future blog entry. For now, we’re pleased to be named a semi-finalist and are hard at work on the next iteration of our proposal.

-Doug Hirano, MPH, APCA Executive Director

World Hepatitis Day

The World Health Organization has designated July 28th as World Hepatitis Day. However, we don’t have to look globally to find a crisis related to hepatitis B infection.

Data from the Arizona Department of Health Services indicate that Asian Americans have constituted 40% of all reported cases of chronic hepatitis B in Maricopa County over the past five years. Considering that Asian Americans constitute only 3% of the population, this is alarming.

Nationally, it is estimated that 1 in 12 Asian Americans is permanently infected with hepatitis B, a virus that attacks the liver. For all other Americans, the rate of chronic hepatitis B infection is just 1 in 1,000. Without medical monitoring and treatment, 25% of individuals with chronic hepatitis B infection will suffer and possibly die due to severe liver cirrhosis and/or liver cancer. The Centers for Disease Control and Prevention (CDC) estimates that 65% of all individuals infected with hepatitis B are unaware of their infection.

These data suggest that nationally there are more Asian Americans undiagnosed with hepatitis B than all Americans undiagnosed with HIV/AIDS. Compared to HIV/AIDS, very little attention is paid to the problem of chronic hepatitis B – particularly among Asian Americans. This is a shame given that a simple blood test can detect the infection and a vaccine exists to prevent infection. We need to continue to spread the word that all Asian Americans get tested and vaccinated for hepatitis B.

In recognition of World Hepatitis Day, we are hosting a free hepatitis B testing and education event at the Vietnamese Community Center, 2051 W. Warner Road, Suite 22, Chandler, from 9 am to 1 pm on Saturday, July 30th. Information will also be provided to help individuals without health insurance coverage to enroll in publicly funded health insurance programs or otherwise find affordable medical care. Further information is available from the Asian Pacific Community in Action at (602) 265-4598 or www.apcaaz.org.