Kitsap Public Health outlines hepatitis C surveillance and a pilot to locate and link lost-to-follow-up patients to treatment

Kitsap Public Health District staff on May 20 presented the district’s hepatitis C surveillance and linkage-to-care work and described a planned one-year pilot to locate and offer treatment navigation to people who tested positive but were not linked to care.

Program manager Kelsey Steadman reminded the board that hepatitis C is a blood-borne virus, often asymptomatic, and that effective curative treatments exist: “There is a cure. So there's medication out now that is over 95 percent effective in treating hepatitis C,” she said.

Steadman explained the district’s surveillance responsibilities for acute, chronic and perinatal hepatitis C infections and described additional FPHS-funded efforts to investigate cases, provide technical guidance to clinicians, and refer people to treatment and social supports. The district participates in state-level data collaboration that uses Apple Health (Medicaid) lab and prescription data to estimate local diagnosis and treatment rates.

State and local figures presented: the Apple Health analysis showed about 1,300 Kitsap residents diagnosed with hepatitis C over the past decade with roughly 40 percent estimated as treated or spontaneously cleared. In 2023 Kitsap had 101 newly reported diagnoses (rate comparable to state averages). Preliminary 2024 work screened approximately 1,500 hepatitis C labs covering over 500 Kitsap residents; staff investigated roughly 300 of those potential or confirmed cases, identified 61 new diagnoses and one perinatal infection, and worked with nine pregnant people to coordinate perinatal follow-up and onward treatment after breastfeeding.

Steadman described barriers: lengthy delays between diagnosis and treatment (median observed time from diagnosis to starting treatment exceeds about 400 days) and difficulties locating patients because contact information and housing status often change. To address that gap, the district applied for grant funding with CommonSpirit and partners, and plans a one-year care‑coordination pilot to identify at least 200 people who tested positive and were lost to follow-up. The pilot will subcontract with an experienced local outreach advocate to perform field outreach, assist with insurance and appointments, provide transportation, and support medication adherence (including weekly med-box delivery in selected cases).

Pilot targets and metrics include locating at least 50 percent of identified people and initiating treatment for at least 60 percent of those who choose treatment and attend at least one appointment; staff will also document barriers and facilitators to guide future work. Steadman noted a statewide goal to eliminate hepatitis C in Washington by 2030 (state directive referenced) and said the district’s pilot is intended to reduce the large gap between testing and completion of curative therapy.

Board members asked about testing among minors, partner jurisdiction work to reinstate Medicaid coverage for incarcerated people, and potential opportunities to initiate treatment during jail stays. Steadman said current testing is often done per provider discretion but that the district prioritizes cases among younger people for follow-up and will support provider education and community outreach.