One of the greatest health threats to veterans is a potentially fatal disease that often does not manifest until years after they leave the battlefield. Veterans are at high risk for the hepatitis C virus. This infectious, blood-borne disease can take years, or even decades, to present symptoms, and by the time individuals feel sick, the disease has likely already taken its toll. While hepatitis C is a growing epidemic across the country, where more than 3.2 million Americans are infected with the virus, it is even more rampant among veterans. Prevalence of hepatitis C among veterans who receive care through the Veterans Health Administration is twice the rate reported in the general population, and the number of infections is estimated to be even higher. Despite the fact that the VA began riskbased screening in 1998, less than half of veterans in VA care have been tested, while veterans who do not receive care through the VA are even more unlikely to be tested at all. Hepatitis C is more prevalent among veterans due to the potential for blood exposure in combat or medical settings. In a VA study, 36 percent of hepatitis C-positive patients reported a history of transfusion; 14 percent reported blood exposure in combat, and 9 percent reported combat wounds. Almost 20 percent reported non-combat occupational exposure to blood or bodily fluids. Most veterans with hepatitis C were likely infected during the Vietnam War. Nationwide, the baby boomer population – a common age group to serve in Vietnam – are more than five times more likely to have hepatitis C. “Hepatitis C is a silent epidemic that is having quite a devastating impact in the veterans community,” said NAVAPD president Samuel V. Spagnolo, M.D. “The majority of those infected don’t realize they have it. All physicians in the VA healthcare system, no matter what our specialty, should promote screenings for this disease.” According to the Department of Veterans Affairs, nearly 7,000 hepatitis C-positive veterans died in 2010 – up from 1,986 in 2001. Meanwhile, the number of hepatitis C-infected veterans diagnosed with liver cancer has increased ten-fold over the last decade, while the number of veterans diagnosed with cirrhosis has tripled to more than 25,000. The Centers for Disease Prevention and Control (CDC), the United States Preventive Services Task Force (USPSTF), and the Centers for Medicare and Medicaid Service (CMS) all recommend a one-time screening test for baby-boomers. For those not in the VA health care system, such testing is covered by Medicare and private insurance plans. Hepatitis C is a life-threatening virus, but there is hope to manage, and even cure, this disease, while treating the catastrophic liver damage it can cause. “I hope the VA medical community can work together, and with our colleagues in private practice, to take action against this often-undetected enemy,” added Spagnolo.