CHARLESTON, W.Va. (AP) – US Senator Joe Manchin on Monday presented an inquiry to Congress with the Centers for Disease Control and Prevention regarding an HIV outbreak in the largest county in West Virginia.
The West Virginia Democrat called for the inquiry on behalf of the Kanawha County Commission two months after a CDC official warned that the county outbreak was “the most worrying in the United States.”
Commission President Kent Carper said in a statement that the outbreak “is a major public health problem and deserves our full understanding”.
In a letter to Dr. Rochelle Walensky, the director of the CDC, Manchin asked the CDC to review the committee’s concerns and respond by Friday.
Later on Monday, Manchin released a letter from the CDC saying he was looking forward to meeting with public health officials. He said that Dr. Jonathan Mermin, director of the CDC’s National Center for HIV-AIDS, would be included in the meeting.
In early February, Dr. Demetre Daskalakis, head of HIV prevention at the CDC, made a presentation at a meeting of an HIV task force in Kanawha County.
“It is possible that the current case count represents the tip of the iceberg,” said Daskalakis. “There are probably many more undiagnosed cases in the community. We are concerned that transmission is underway and that the number of people with HIV will continue to increase unless urgent action is taken. “
The commission’s letter to Manchin asked whether the CDC had completed an official investigation into the rise of HIV in the county. The letter states that the commission is concerned that the statements that refer to the outbreak as the most worrying in the country “are being made without factual and empirical evidence”.
By 2014, only 12.5% of HIV cases in West Virginia were a result of intravenous drug use. In 2019, 64.2% were, according to data from the state health department. The increase was mainly due to the clusters in Kanawha and Cabell counties.
Kanawha County, which includes Charleston and has 178,000 residents, had two cases of HIV related to intravenous drugs in 2018. The number grew to 15 in 2019 and at least 35 last year, said Shannon McBee, a state epidemiologist.
In comparison, New York City, with a population of more than 8 million, registered 36 HIV cases linked to intravenous drug use in 2019, according to the CDC. Counties in other states with populations similar to Kanawha had an average of less than one HIV diagnosis among people who inject drugs, Daskalakis said.
The increase, concentrated mainly around the capital Charleston and the city of Huntington, is being attributed, at least in part, to the cancellation in 2018 of a needle exchange program that offered clean syringes to injecting drug users who were unable to quit smoking altogether.
Needle exchange programs are included in the CDC’s recommendations for controlling disease outbreaks among intravenous drug users. These programs exist in dozens of states, but they have their critics, including in West Virginia, who say they don’t do enough to prevent or stop drug use.
With less than a week to go for the regular session, the state legislature is considering a bill to regulate needle exchange suppliers.
The nonprofit Solutions Oriented Addiction Response provides addicts with clean needles in Charleston and shares information about HIV testing with residents, including homeless people. SOAR co-founder Sarah Stone said the legislation could end her group’s needle exchange program.
Citing the pending state bill, the Charleston City Council on Monday night postponed voting on a needle exchange bill until April 19.