Hundreds of thousands of people are to be encouraged to have their blood tested for hepatitis C, a potential killer that can take decades to show itself.
People who have had a blood transfusion before 1991, kidney dialysis, surgery or dental treatment in countries with high infection rates, or experimented with injecting drugs earlier in life are among those to be targeted under a strategy for tackling the disease in England recommended by a government advisory group yesterday.
Ministers will establish clinics where people who might unknowingly carry the disease can be screened, and step up testing in drug treatment centres and prisons. The virus, identified in the 1980s, is diagnosed in more English people than HIV, but infection is curable, with up to half those given medication being cleared. Lifestyle changes, such as cutting alcohol consumption, also help people live with the infection.
So far 26,500 people in England have been diagnosed, but only an estimated one in 10 of those carrying the virus is identified, so the government might be facing a public health timebomb, with untold misery for patients and a financial crisis for the NHS. Already 100 people a year are dying from hepatitis C infection and the virus is often a factor in cirrhosis of the liver and liver cancers which kill 5,000 people a year.
Some health campaigners want an advertising campaign like that which accompanied the Aids outbreak in the 1980s. Others think a "non-alarmist" public education campaign through GP surgeries, schools and other less official channels might be enough to help identify up to 200,000 people who do not know they are infected. Just over £1m has been set aside for publicity.
Blood services have screened for hepatitis C since 1991 and told donors why their blood is being rejected. Thousands of haemophiliacs were infected before anti-viral treatments were introduced in 1984. But many people in risk categories might be reluctant to go to clinics treating drug addiction or sexually transmitted diseases.
The most common way of catching the virus is injecting drugs with contaminated equipment, although it can be sexually transmitted, passed from mother to baby and spread through shared toothbrushes or shavers. The infection cannot be spread through normal everyday contact.
For every 100 people infected, 20 will clear the virus from their body naturally within six months. Of the 80 left, a quarter will never show liver damage or physical symptoms. The remaining 60, however, may experience weight loss, muscle aches, depression, nausea or liver disease. Of those, 16 will develop cirrhosis over 20 years, and one or two of them will then contract liver cancer. People over 40 when first infected develop disease more quickly.
Pat Troop, the deputy chief medical officer, said: "It is essential we intensify our efforts to prevent new cases and to diagnose and treat those who are already infected."
· The government is to offer thousands of women testing for chlamydia, a sexually transmitted disease which often has no symptoms but which can lead to inflammation of the pelvis and infertility. New diagnoses in women rose by 10% last year.
