Breaking the Silence on a Deadly Epidemic

What if you were told there was a silent epidemic infecting one in 10 Asian Pacific Americans? That this disease is considered one of the top five leading causes of death for Asian Pacific Islander men living in California? That half of the 20,000 women in the United States who give birth each year and have this chronic infection are Asian Pacific Islander?

What would you do?

Some Asian American community leaders including Ted Fang, co-founder of the San Francisco Hep B Free campaign, joined by several lawmakers, says it’s time to make viral hepatitis, a disease that leads to inflammation of the liver, a national priority. They are responding in part to an announcement this fall by Dr. Thomas Frieden, chief of the Centers for Disease Control and Prevention, who came out with a list of six “winnable battles,” which include smoking, AIDS, obesity/nutrition, teen pregnancy, auto injuries and health care infections. The list stirred quite a bit of controversy because some argued these conditions are, in effect, already national priorities, receiving a great deal of attention and government resources.

Meanwhile, viral hepatitis, remains largely unknown among the general public, as well as policymakers, despite the fact that it is the fourth leading infectious cause of death in the United States. An estimated 1.25 million Americans are chronically infected with hepatitis B (one of three of the most common types of viral hepatitis, along with hepatitis A and hepatitis C), with more than half of the infected being Asian Pacific Islander Americans, according to the Asian Liver Center at Stanford University. While one in 10 Asian Pacific Americans is infected in the U.S., that compares to one in 1,000 among Caucasians, so this is clearly an especially important health issue for our ethnic community.

On a global scale, there are about 350 million people with chronic hepatitis B infection, and an estimated 78 percent of them live in Asia or the Pacific Islands.

Often dubbed the “silent epidemic,” an estimated 70 percent of persons with it do not know they are infected and risk transmitting the disease. And, yet, there are vaccinations to prevent two of the most common forms, hepatitis A and hepatitis B.

For those infected with viral hepatitis, without treatment, 15 to 40 percent will develop liver cirrhosis. An estimated 5,000 people in the U.S. die each year from hepatitis B virus-related liver cancer or cirrhosis with liver failure.

Despite these alarming facts, there remains a dearth of government leadership, public knowledge of and resources for viral hepatitis. Fang, whose Hep B Free campaign strives to turn San Francisco into the first hepatitis B-free city in the nation with free and low-cost testing and vaccinations, says without public outcry, there is no political will to get this epidemic on the map.

In a recent letter to the CDC, 16 lawmakers, including Congress members Judy Chu (D-Calif.) and Mike Honda (D-Calif.), demanded a “clear plan” for how the CDC will combat the disease. They called its omission from the list of six CDC priorities “glaring.” Their bottom line message: this, too, is a winnable battle if given the proper attention and resources. It’s an epidemic that shouldn’t remain “silent.”