State health officials say between 3.5 to 4 million Americans are living with viral hepatitis. In 2006, there were 4,723 reported cases of chronic and acute hepatitis C in Indiana, as well as 80 cases of hepatitis B, 33 cases of hepatitis A, and one case of hepatitis E. To address the problem in the state, the Indiana Viral Hepatitis Advisory Council has released "Indiana's Strategic Plan for the Prevention, Care, and Elimination of Viral Hepatitis."

"The purpose of the plan is to help our state move forward in raising awareness of viral hepatitis, to provide additional education and support for those living with the disease and their loved ones, and to ultimately reduce the burden of viral hepatitis in Indiana," said State Health Commissioner Judy Monroe, M.D.

The "Strategic Plan for the Prevention, Care, and Elimination of Viral Hepatitis" is divided into four main principles: surveillance; prevention and education; comprehensive care; and grants, legislation, and policy. Each section includes objectives and action items guiding specific goals.

Hepatitis is an inflammation of the liver. The liver is the body's largest internal organ and filters everything that an individual eats, breathes, absorbs through the skin, or comes in contact with. Many things can cause the liver to become inflamed, but the most common sources are hepatitis A, B, and C. Hepatitis D and E are serious but less common forms of hepatitis. Hepatitis D is only found in individuals who are already infected with hepatitis B and hepatitis E is extremely rare in the United States: • Hepatitis A is a liver disease that can cause tiredness, stomach pain, nausea, diarrhea and jaundice. It rarely causes long-term damage or death. It can be spread by eating or drinking contaminated food or water, or by eating something contaminated by an already infected person.

The best protection is frequent and thorough hand washing. Be sure to also cook food thoroughly, especially meat. A vaccine is available for this disease. • Hepatitis B is a serious disease of the liver that can lead to severe illness, liver damage or even death. It is spread by direct contact with blood or certain body fluids of an already infected person. It can also be spread through shared household items like razors or toothbrushes. A safe and effective vaccine is available and recommended for all children and other at risk individuals. • Hepatitis C is a liver disease found in the blood of infected people. It is primarily spread through direct contact with the blood of an infected person. Symptoms include a yellowing of the skin and eyes, nausea, vomiting, fever and tiredness. Most people with hepatitis C have no symptoms, but can still infect others, while others become very ill and some may never fully recover.

In January 2009 a new group, the Indiana Viral Hepatitis Strategic Planning Implementation Committee, will convene to put the plan into action. A copy of the plan can be found on the Indiana State Department of Health Web site at: www.statehealth. in.gov by clicking on the "Viral Hepatitis" link under "Health Information by Topic" on the left hand side of the page."