After 30 years of having hepatitis C, nurse Jennifer Slepin was cured from the disease in 2016. But then she was faced with a dilemma — what to do with herself now that she was a survivor? “Who will I be without hepatitis C?” The answer took her on the road across America. This month it takes her to Plumas County.
Slepin is hoping to make a difference here in Plumas County. Using census data of the 3,500 counties in the United States, 225 have been assessed for vulnerability for Hep C infection. Eleven counties in California show high criteria for vulnerability (all in rural northern and northeastern counties with a few rural eastern southern counties). Plumas comes up with the highest per capita “vulnerability to infection.” Much of that has to do with rural access to testing and in Slepin’s estimation — stigma in getting tested for either HIV or Hep C.
Her mission is to have conversations with rural health care providers about Hep C and testing for it. These days, Slepin says, the cure for Hep C is fairly simple and people need access to it.
Historically, Hepatitis C hits baby boomers and drug users who use needles more than any other part of the population. Baby boomers often suffer from it because of how vaccinations were once delivered in the 1950s and ’60s — often with needles reused in every child with only an alcohol swap in between vaccinations of children. Intravenous drug use also transmits the disease as can tattoo and piercing needles that have not been cleaned. Basically, any sharing of a needle or tool that has remnants of blood that has been infected can transmit. Slepin thinks it shouldn’t matter how someone got it — what matters to her is that people get cured.
Hep C is hard to diagnose without screening as people may be asymptomatic for years. It can feel like the flu and bring on fatigue, muscle and joint pain, upset stomach and loss of appetite.
It attacks the liver with long term and chronic infection.
Slepin turns up her hands to show palms that are red and blotchy — the scar of Hepititis C is still there long after the cure. Even cured it has left her with cirrhosis of the liver. She realized she might have it from noticing she looked jaundiced (yellowing skin and eyes).
Slepin wants others to not suffer any more from the disease they probably don’t know they even have. In rural America is where basic HCV screening is lacking the most. When she got cured she was driving a Prius; she traded it in for a truck and now hauls an Airstream around the country with the nonprofit organization she founded called HepCarestream.
HepCarestream educates healthcare providers through an entity called Project ECHO (Extension for Community Healthcare Outcomes). University of California, San Francisco is an ECHO “hub” started by Dr. Norah Terrault. The rural patients with Hep C do not have to leave the area to be treated, but instead are seen by their own healthcare provider with ECHO providing the education on treatment and care plan remotely — akin to telemedicine, if you will.
Because of the anti-viral cure found to treat Hep C and cure patients, the Center for Disease Control and the World Health Organization have set a goal of eradicating Hep C by 2030. The cure takes eight to 12 weeks. Slepin with HepCarestream hopes to play her part in that eradication with these travels across country to increase awareness and knowledge and get people screened and on the road to recovery.
In Slepin’s first six months on the road she “never came across an American who didn’t know someone who had it — whether it was a baby boomer like herself or an opioid drug user.” Everyone knew someone. This, she says, affects all of us.
In rural areas her Airstream can be seen near harm reduction centers, needle exchanges and public health centers.
“It’s a disservice to people not to make them aware that there’s a cure,” Slepin says. She speaks of time spent in Humboldt County. When she arrived only three doctors were providing Hep C treatment. When she left 24 were.
She speaks of recent work in rural California where 28 people were tested, 12 tested positive, seven are in the process of the cure and two are cured. It’s her passion and calling to see the number of cured patients rise.
For her part in Plumas County, she has already been meeting providers in the short time since she arrived last week. She hopes to hit all clinics and hospitals in the county and help get the ball rolling towards care.
Meanwhile she’ll be in that Airstream and meeting around the county hoping to convince people to be screened so they can be cured.
For more information on Slepin’s nonprofit, readers can check out HepCarestream.org.