Law Enforcement And Crime
There are about 18,000 U.S. police agencies from local to federal level in the United States. Law in the United States is mainly enforced by local police departments and sheriff‘s offices. The state police provides broader services, and federal agencies such as the Federal Bureau of Investigation and the U.S. Marshals Service have specialized duties, such as protecting civil rights, national security and enforcing U.S. federal courts‘ rulings and federal laws.State courts conduct most civil and criminal trials, and federal courts handle designated crimes and appeals from the state criminal courts.
As of 2020, the United States has a intentional homicide rate of 7 per 100,000 people. A cross-sectional analysis of the World Health Organization Mortality Database from 2010 showed that United States homicide rates “were 7.0 times higher than in other high-income countries, driven by a gun homicide rate that was 25.2 times higher.”
National Trends For Chronic Hepatitis B
The trends in reported cases of chronic HBV infection between 2009 and 2018 are presented below. Ten out of 13 P/Ts reported on chronic HBV infection in 2018.
3.2.1 Overall trends over time
In 2018, a total of 3,483 cases of chronic HBV were reported in Canada, corresponding to a national rate of 10.6 per 100,000 population. The overall rate of reported chronic HBV decreased by 21% since 2009 . This trend was seen among both males and females . Rates of reported chronic HBV infection have been consistently higher among males than females between 2009 and 2018 .
Figure 3. Number of reported cases and rates of chronic HBV infection by sex in CanadaFigurenote 3 *, CNDSS, 2009 to 2018
This graph displays the overall number of reported cases, as well as the overall and sex-specific rates of reported chronic hepatitis B cases, between 2009 and 2018 in Canada. The horizontal axis shows the calendar years from 2009 to 2018. The vertical axis shows the rate of reported chronic hepatitis B cases per 100,000 population for males, females, and overall, as well as the total number of reported cases of chronic hepatitis B.
3.2.2 Rates of chronic hepatitis B infection by age group and sex
In 2018, for both males and females, the highest rates of reported cases of chronic hepatitis B occurred in the 30 to 39 year age group .
Figure 4. Rates of reported cases of chronic HBV infection by sex and age group in CanadaFigurenote 4 *, CNDSS, 2018
Hepatitis C By Sex And Age Groups
- In 2019, 61% of reported hepatitis C cases were male
- In 2019, the rate of hepatitis C among males was 37.4 per 100,000 males and among females was 23.2 per 100,000 females
- In 2019, among males, those aged 25 to 39 had the highest rates of hepatitis C
- In 2019, among females, those aged 25 to 39 had the highest rates of hepatitis C
- From 2015 to 2019, total hepatitis C rates were consistently higher for males than females
- From 2015 to 2018, among males, the rate of hepatitis C increased
- From 2018 to 2019, among males, the rate of hepatitis C decreased by 10%
- From 2015 to 2018, among females, the rate of hepatitis C increased
- From 2018 to 2019, among females, the rate of hepatitis C decreased by 11%
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Why Are Baby Boomers At A Higher Risk
Even though baby boomers are no longer the only age group at higher risk of hepatitis C, there may still be risk factors associated with this age group.
The biggest reason baby boomers were thought to be more likely to have hepatitis C was due to unsafe medical procedures at the time. In the past, doctors had no protocol or screening method to check if a blood supply was virus-free.
A points to unsafe medical procedures of the time rather than drug use as the primary reason behind hepatitis C transmission in baby boomers. Researchers behind the study found that:
- The highest number of new transmissions occurred before 1965.
- The highest transmission rates happened through the 1940s and early 1960s.
- The population with hepatitis C stabilized between 1965 and 1989.
These findings counter the stigma of drug misuse around the disease. Most baby boomers were far too young to use drugs or engage in sexual activity.
The risk baby boomers are subject to is also a matter of time and place: They came of age before hepatitis C was identified and routinely tested for.
Who Is Most At Risk Of Contracting Hepatitis C
You have a high risk of contracting hepatitis C if you:
- use or have used injection drugs even if it was just once or many years ago
- have received blood or blood products or an organ transplant before July 1990 in Canada
- have been in jail or
- have been injected or scratched during vaccination, surgery, blood transfusion or a religious/ceremonial ritual in regions where hepatitis C is common.
You have a high moderate risk of contracting hepatitis C if you:
- have tattoos or body piercing
- have multiple sexual partners
- have a sexually transmitted infection , including HIV or lymphogranuloma venereum
- have experienced traumatic sex or rough sex or have used sex toys or fisting that can tear body tissue
- have vaginal sex during menstruation
- have received a kidney treatment
- have received an accidental injury from a needle or syringe
- have another infectious disease
- were born to a hepatitis C infected mother or
- have a sexual partner infected with hepatitis C.
Hepatitis C is NOT passed from person to person by:
- coughing, sneezing
- breastfeeding unless your nipples are cracked and bleeding or
- oral sex, unless blood is present.
Health Care Worker Transmission
Unapparent blood contact causes HCV transmission. Therefore, in addition to patients, health care workers may be at risk of contracting HCV infection in the event of accidental exposure to the blood of infected individuals. Studies reveal, if one ignores the limitations of the data, an average risk after parenteral exposure of 1.9% .
Getting Tested For Hepatitis C
Seek medical advice if you have persistent symptoms of hepatitis C or there’s a risk you’re infected, even if you do not have any symptoms.
A blood test can be carried out to see if you have the infection.
GPs, sexual health clinics, genitourinary medicine clinics or drug treatment services all offer testing for hepatitis C.
Early diagnosis and treatment can help prevent or limit any damage to your liver, as well as help ensure the infection is not passed on to other people.
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What Is Hepatitis C
Hepatitis C is a liver infection that can lead to serious liver damage. Itâs caused by the hepatitis C virus. About 2.4 million people in the U.S. have the disease. But it causes few symptoms, so most of them don’t know. The virus spreads through an infected personâs blood or body fluids.
There are many forms of the hepatitis C virus, or HCV. The most common in the U.S. is type 1. None is more serious than any other, but they respond differently to treatment.
List Of Appendices And Supplementary Tables And Figures
Copies of the appendices and supplementary tables are available upon request. Please email the staff of the STI and Hepatitis Surveillance Section, Public Health Agency of Canada at .
Any comments and suggestions that would improve the usefulness of future publications are appreciated and can likewise be sent to the above email address.
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Liver Assessment Before Treatment
Blood tests can assess the state of your liver. Your healthcare provider can calculate an APRI score, which can rule out the presence of liver damage in many people. These people can be treated immediately by their GPs. Some people will need to be referred to their local hepatitis C service for a fibroscan.
Everyone should have a fibroscan before starting hepatitis C treatment. It’s important to know how much scar tissue or damage is present. If you have mild or moderate scarring in the liver, your GP can supervise your treatment. After successful treatment no further follow-up is needed. Scar tissue in the liver will reduce over time.
If severe scar tissue is present in the liver, you should be cared for by a specialist clinic. After treatment you should stay under specialist follow-up because there is a risk of liver cancer , even many years after the virus has been cured.
What happens after treatment?
Being cured of the hepatitis C virus means having a sustained virological response , which is when the virus can’t be detected three months after treatment.
This is a complete cure from hepatitis C, as being free of the virus three months after treatment means it is unlikely the virus will return. However, you are not immune to hepatitis C and you can be reinfected if you’re exposed to the virus again.
What Should People Do If They Think They Have Been Exposed To Hcv
- Antibody detection tests: The antibody detection test determines the presence of antibodies of the virus, indicating exposure to HCV. An antibody is a substance found in the blood that the body produces in response to a virus. A doctor will likely order a second test to confirm whether the virus is still present in the bloodstream.
- Virus detection tests: The virus detection test identifies whether the virus is still present, indicating an active infection of HCV. This test may also be used after treatment to determine if the virus has been eliminated from the body.
- Liver biopsy: A liver biopsy is a procedure to remove a small piece of the liver so it can be examined with a microscope for signs of damage or disease. A liver biopsy is not necessary for diagnosis but is used to determine the severity of the disease and permanent damage. It is also helpful in determining the cause of the damage.
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Global Efforts To Improve Delivery Of Hepatitis B Vaccine During Infancy
The safe and effective hepatitis B vaccine has dramatically reduced the number of new hepatitis B virus infections reported worldwide, but many unvaccinated children continue to become infected. The biggest gap in vaccination coverage is caused by the failure to administer a first dose of vaccine within 24 hours of birth. This dose protects infants, particularly infants born to HBV-infected mothers, from the virus. According to WHO, only 43% of children worldwide received a birth-dose of hepatitis B vaccine in 2019 .
Learn more about CDCs work to prevent hepatitis B globally.
How Is Hepatitis C Treated
There are some very effective options for the treatment of hepatitis C infection. They are listed on the Medicare PBS , which makes them available at a much lower cost.
Newer treatments differ from those available previously:
- they cure more than 95% of people
- their side effects are minimal
- treatments last just 8 to 12 weeks
- they involve just a few pills each day, with no injections required
Curing hepatitis C means clearing the virus from the body. It helps reduce liver inflammation and can also help reverse scarring and cirrhosis. You can be re-treated if your treatment doesnt work the first time.
You should check with your doctor before taking any other medication or supplements, and whether you need vaccinations against hepatitis A and hepatitis B. You should also avoid alcohol if you have hepatitis. If you have liver damage, you may also need to see a liver specialist
For more information on how to get treatment, contact the National Hepatitis Info Line on 1800 437 222.
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How Can You Tell If You Have Chronic Hepatitis C
While most people dont feel unwell even with chronic hepatitis C, this isnt true for everyone. Some potential signs and symptoms of chronic hepatitis C that has led to liver damage include:
- Swelling of the legs or ankles
- Accumulating fluid in the abdomen
- The appearance of spidery blood vessels on the skin
- Drowsiness, confusion, and slurred speech
Without treatment, a hepatitis C infection can cause severe liver damage and, potentially, liver failure, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Within 20 years of becoming infected, 5 to 20 percent of people with hepatitis C develop cirrhosis of the liver, says the CDC.
Hepatitis Infections In The Us And Worldwide
If you’ve been diagnosed with one of the forms of hepatitis, you aren’t alone. It’s thought that roughly two percent of people in the United States are living with a chronic hepatitis B or hepatitis C infection, not to mention the other three forms. Hepatitis can cause illness or death due to both the symptoms of the infection and to complications that may develop.
Worldwide, hepatitis was responsible for 1.34 million deaths in 2015. The World Health Organization also reports that deaths from hepatitis have increased 22 percent since 2000.
Hepatitis B and hepatitis C are responsible for 96 percent of deaths from viral hepatitis of any kind worldwide and cause an estimated 78 percent of all liver cancer and 57 percent of all liver cirrhosis.
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Rate Of Total Hepatitis C By Province And Territory
From 2018 to 2019, total hepatitis C rates declined in nine provinces and territories. This decline ranged from -4% to -40%.
- In Nova Scotia, between 2018 and 2019, hepatitis C rates remained stable
- In Prince Edward Island, between 2018 and 2019, hepatitis C rates increased by 15%
- Rate changes were not reported for the Northwest Territories or Nunavut since there were five or fewer hepatitis C cases reported in 2019
In 2019, the national rate of total hepatitis C was 30.4 per 100,000 people. Provinces and territories that had rates of total hepatitis C above the national rate included:
- Newfoundland and Labrador
- British Columbia
- Prince Edward Island
- New Brunswick
In 2019, in Alberta, the rate of total hepatitis C was 30.4 per 100,000 people. This matched the national rate of total hepatitis C.
In 2019, provinces and territories with rates of total hepatitis C below the national rate of 30.4 per 100,000 people included:
- Northwest Territories
How Do You Get Hepatitis C
The hepatitis C virus is usually spread through blood-to-blood contact.
Some ways the infection can be spread include:
- sharing unsterilised needles particularly needles used to inject recreational drugs
- sharing razors or toothbrushes
- from a pregnant woman to her unborn baby
- through unprotected sex although this is very rare
In the UK, most hepatitis C infections happen in people who inject drugs or have injected them in the past.
It’s estimated around half of those who inject drugs have been infected with the virus.
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Indigenous Peoples And Pre
It is generally accepted that the first inhabitants of North America migrated from Siberia by way of the Bering land bridge and arrived at least 12,000 years ago however, some evidence suggests an even earlier date of arrival. The Clovis culture, which appeared around 11,000 BC, is believed to represent the first wave of human settlement of the Americas. This was likely the first of three major waves of migration into North America later waves brought the ancestors of present-day Athabaskans, Aleuts, and Eskimos.
Over time, indigenous cultures in North America grew increasingly complex, and some, such as the pre-Columbian Mississippian culture in the southeast, developed advanced agriculture, architecture, and complex societies. The city-state of Cahokia is the largest, most complex pre-Columbian archaeological site in the modern-day United States. In the Four Corners region, Ancestral Puebloan culture developed from centuries of agricultural experimentation. The Haudenosaunee, located in the southern Great Lakes region, was established at some point between the twelfth and fifteenth centuries. Most prominent along the Atlantic coast were the Algonquian tribes, who practiced hunting and trapping, along with limited cultivation.
How Is Hepatitis C Infection Prevented
Unfortunately, there is no vaccine to prevent hepatitis C. To reduce your risk of getting hepatitis C:
- Injection drug use is the most common way people get hepatitis C. Avoid injecting drugs to reduce your risk. If you do inject drugs, use sterile injection equipment. Avoid reusing or sharing.
- Avoid sharing personal care items that might have blood on them
- If you are a health care or public safety worker, follow universal blood/body fluid precautions and safely handle needles and other sharps
- Consider the risks if you are thinking about tattooing, body piercing, or acupuncture are the instruments properly sterilized?
- If youre having sex with more than one partner, use latex condoms correctly and every time to prevent the spread of sexually transmitted diseases, including hepatitis C.
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People Who Inject Drugs
People who inject drugs are at high risk of acquiring hepatitis C. The number of new cases in this group of people among those aged 1840 years has shown to increase steadily since 2013. The latest figures from 2019 indicate there are 2.8 cases per 100,000 population.
As a result, the government is attempting to reduce these rates by 2025. However, a reduction of 39.3% from the 2019 figures is necessary to meet the 2025 goal of 1.7 cases per 100,000 population.