Laboratory confirmed cases must be reported to the Thunder Bay District Health Unit by fax, phone or mail.
- Fax: (807) 625-4822
- Phone: 625-8318 or toll-free at 1-888-294-6630, ext. 8318
- Mail: 999 Balmoral Street, Thunder Bay, ON P7B 6E7
The hepatitis C virus (HCV) is a small, single-stranded RNA virus and is a member of the Flaviviridae family. At least 6 major genotypes and approximately 100 subtypes exist. There is limited evidence about any differences in clinical outcome between the various types; however, differences do exist in responses to antiviral therapy according to HCV genotypes.
Most cases are usually asymptomatic or have mild illness; presentation is similar to other hepatitis diseases and when symptoms are present, the onset is slow and insidious with anorexia, vague abdominal discomfort, nausea and vomiting and fatigue. A high percentage (50-80%) of infected persons develop chronic infection..
Modes of transmission:
HCV is primarily transmitted by blood-to-blood contact (parenterally). Sexual and mother-to-child have been documented but appears far less efficient or frequent than the parenteral route.
Ranges from 2 weeks to 6 months, most commonly 6-9 weeks.
Period of Communicability:
From one or more weeks before the onset of symptoms; most persons are probably infectious indefinitely.
Blood transfusion; co-infection with existing STI; invasive surgical/dental/ocular procedures; organ/tissue transplant
Inhalation/injection drug use; shared drug equipment or personal items; tattoo/piercing; electrolysis/acupuncture; high risk sexual practices; occupational exposure; sexual partner is HCV positive; blood exposure (fighting, accident)
Diagnosis & Laboratory Testing
Two serology tests can screen for chronic Hepatitis C infection for patients with risk behaviours or potential past exposures to HCV:
1. anti-HCV testing to assess for previous exposure (if positive, the patient will have antibodies for life) and
2. HCV-RNA testing to check for active virus.
For the RNA test, 2.5 ml of frozen serum, separated within 4 hours of collection (at the lab) must be submitted to an Ontario Public Health Laboratory with a completed Hepatitis PCR Requisition.
Treatment & Case Management
The Primary Care Management of Chronic Hepatitis C – Professional Desk Reference 2009 provides guidelines for who should be screened, determining chronic Hepatitis C infection, evaluation, education, and counseling of the HCV infected adult, and assessing for acute Hepatitis C infection.
Hepatitis C (HCV) – Counselling Guidelines for Health Care Professionals (HCP) (PDF) resource was developed for health care professionals by the Thunder Bay District Health Unit.
- Ministry of Health and Long Term Care, Infectious Diseases Protocol, 2018; Appendix A (2018) and Appendix B (2018).
- CMAJ. "The management of chronic hepatitis C: 2018 guideline update from the Canadian Association for the Study of the Liver."
- Can J Gastroenterology. "Management of chronic Hepatitis C: Consensus Guidelines, 2015."
- Can Association for the Study of the Liver. Online app to access and navigate the "Management of chronic Hepatitis C: Consensus Guidelines, 2015."
- Canadian Liver Foundation. "Healthy Living with Viral Hepatitis."
- Healthy Canadians, Government of Canada, "Hepatitis C."
- Canadian AIDS Treatment Information Exchange (CATIE). "Hepatitis C."