Hepatitis C

Reporting Obligations

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


Aetiologic Agent:

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.

Clinical Presentation:

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.

Incubation Period:

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.


Risk Factors/Susceptibility


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.

Testing Information & 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.

The patient is eligible for free Hepatitis A and B vaccines. To order, please use the appropriate vaccine order form; hepatitis A or hepatitis B.


Patient Information

Patient Fact Sheet


  1. Ministry of Health and Long Term Care, Infectious Diseases Protocol, 2018; Appendix A (2018) and Appendix B (2018).
  2. CMAJ. "The management of chronic hepatitis C: 2018 guideline update from the Canadian Association for the Study of the Liver."


Additional Resources

  1. Can J Gastroenterology. "Management of chronic Hepatitis C: Consensus Guidelines, 2015."
  2. Can Association for the Study of the Liver. Online app to access and navigate the "Management of chronic Hepatitis C: Consensus Guidelines, 2015."
  3. Canadian Liver Foundation. "Healthy Living with Viral Hepatitis."
  4. Healthy Canadians, Government of Canada, "Hepatitis C."
  5. Canadian AIDS Treatment Information Exchange (CATIE). "Hepatitis C."
Last Updated: 11/04/2019