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MONROE COUNTY, Ind. (December 22, 2015) – A public health emergency has been declared for Monroe County amid a hepatitis C epidemic. This allows the county health department to establish a syringe exchange program as part of a broader effort to reduce the spread of hepatitis C.

“Monroe County is experiencing an epidemic of hepatitis C tied to intravenous drug use,” said Dr. Adams. “The syringe exchange is part of a comprehensive approach that will connect residents with treatment, healthcare and other services critical to improving their health and halting the spread of disease.”

Senate Enrolled Act 461 made syringe exchange programs legal in Indiana for the first time. The law sets forth the procedural and substantive requirements that local communities must meet in order for an emergency declaration to be considered by the state health commissioner.

Steps in the process for local communities:

Local health officer must:

  • Declare that an epidemic of Hepatitis C or HIV exists
  • Determine that it is primarily transmitted through IV drug use
  • Deem that a syringe exchange program is medically appropriate as part of a comprehensive response

County commissioners must:

  • Hold a public hearing
  • Take official action adopting the declarations of the local health officer (above)
  • Describe other actions taken regarding the epidemic that have proven ineffective
  • Request a public health emergency declaration from the state

By declaring this public health emergency, the state health commissioner concurs with the declarations of the local health officer and county commissioners. By law, specific aspects of design and implementation of the program are left to local officials. No federal or state funding is appropriated for syringe exchange programs.

“What it means is that the local health officer has declared that there is an outbreak which means then access or more of reported cases than what it would be expected to see over the past five years,” said Pam Pontones, State Epidemiologist for the Indiana Department of Health.

The number of cases in Monroe County is up from just 93 cases in 2010. State officials say, intravenous drug use stemming from heroin abuse, is likely to blame.

“Reducing injection drug use is really a key way to eliminating the spread of Hepatitis C or HIV as well,” said Pontones.

After the state declared an emergency there, Monroe County health officials are able to implement a needle exchange program. Getting addicts to use clean needles is the state’s way to slow the surge.

It’s the same program that was implemented in Scott County, where nearly 200 new cases of HIV sprung up seemingly overnight this summer. It was the largest rural HIV outbreak in the country’s history.

“I think this really illustrates that there’s more rural communities vulnerable to having dramatic increases in HIV whenever you have injection drug use,” said Dr. William Yarber, a public health professor at Indiana University, and the Director of the Rural Center for STD and AIDS prevention.

Rural areas Yarber says are more likely to see outbreaks and less likely to see fast and easy solutions. Many of the state’s resources Yarber says are concentrated in urban areas like Indianapolis and the Chicago suburbs.

“This is going to have a lasting impact. Over $80 million in lifetime healthcare in Scott County, I mean that’s one part of it of course economics, but how about the human suffering?” he said.

The public health emergency will last through December 20, 2016. Monroe County is now the fourth county in the state to utilize a needle exchange program because of a disease outbreak.

For questions regarding the syringe exchange program, contact Kathy Hewett at the Monroe County Health Department at (812) 349-2722.

Visit the Indiana State Department of Health at for important health and safety information, or follow us on Twitter at @StateHealthIN and on Facebook at

Hoosiers who do not have health care coverage or access to a doctor are encouraged to check availability for the new Healthy Indiana Plan—HIP 2.0—by visiting or calling 1-877-GET-HIP-9.