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NASHVILLE - With Tennessee cases of acute Hepatitis C cases more than tripling from 2006 to 2012, the state Department of Health has issued a public health advisory urging residents to get up to speed on the deadly liver-destroying disease.

State Health Commissioner John Dreyzehner said the 364 percent rise of acute Hepatitis C in Tennessee, Kentucky, Virginia and West Virginia may only represent "the tip of the iceberg of a Hepatitis epidemic."

Often associated with intravenous drug use and unsanitary instruments used in tatooing or piercing, the disease in both its forms -- acute and chornic -- is often spread by direct contact with blood from an infected person. 

In a May 2015 report from the U.S. Center for Disease Control and Prevention, the CDC says that over the seven-year period Tennessee and the other states reported a total of 1,377 cases of acute HCV infection to the federal agency.

Dreyzehner, a physician, meanwhile, is warning there could be huge numbers of Tennesseans with chronic Hepatitis C.

"In addition to reported cases of acute Hepatitis C it is estimated that more than 100,000 Tennesseans may be living with chronic Hepatitis C and not know it," Dreyzehner said in the department's news release. "Many people have Hepatitis C for years, not realizing it, while the viral infection slowly destroys their livers."

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There is no vaccine to prevent Hepatitis C, so efforts to avoid exposure to infected blood are most important in preventing the spread of the disease. Drugs to treat the disease are expensive. Most of the increase in transmission of Hepatitis C in Tennessee, officials say, is due to the sharing of contaminated needles and syringes among intravenous drug users who are abusing both legal and illegal pain medicine.

Once infected with Hepatitis C, some people may recover fully, but most, 70 to 85 percent, will develop long-term infection. officials say. Early symptoms can include fatigue, abdominal pain, itching and dark urine.

 Many people, the commissioner warns, are not aware they have the disease until the virus has already caused liver cancer or liver damage.

"We strongly encourage those who suspect they might be infected to seek testing as soon as possible," Dreyzehner said. 

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