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CASPER, Wyo. (AP) — At least 72 people have now been infected by hepatitis in Natrona County, and health officials are trying to determine how to best target their prevention efforts.

The number of cases — almost as many as were reported between 1999 and 2002 — is up from the 57 cases of hepatitis B and C that were confirmed between February and two weeks ago, according to state hepatitis coordinator Clay Van Houten.

The U.S. Centers for Disease Control and Prevention has been distributing a nine-page, confidential survey to those being tested for the liver diseases.

Casper-Natrona County Health Department spokesman Marty Thone said the confidentiality provision will make for honest answers about possible transmission routes. But Casper infectious disease specialist Dr. Mark Dowell is skeptical.

"Some people don't feel comfortable talking about it," he said. "They think that they will be identified as someone who uses drugs. We are not out to police, though, we just want to help. That's what we're here for.

"We count on people being honest even though they might not feel comfortable, because then we can help them and it's more of a team effort."

The questions cover sexual habits, including number of partners; and drug use, including the age of the first use of intravenous drugs and when the person being tested had injected drugs within the past month.

"The first three questions have to do with drug use, especially injected drug use, and with multiple sex partners," Thone said. "If people answer no to the first two questions, then we don't typically test them since they wouldn't be at a high risk."

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Those tested also are asked to list the people with whom they had sexual contact or shared needles. The CDC uses the list to track down potential carriers and inform them of the transmission.

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"People are usually fairly receptive when we call them," Dowell said. "They want to know what is going on with themselves, and although it comes as more of shock to some than others, in the end they typically want to know."

HIV tests also are being administered with the hepatitis tests, but so far no one has been confirmed HIV-positive, Van Houten said.

While people considered at high risk of hepatitis are being tested free of charge, others must pay a fee.

State Epidemiologist Carl Musgrave suspects that the increase in hepatitis B and C is the result of a spike in intravenous methamphetamine use. "It is not just injections, though, and the researchers want people to know that it is also transmitted by multiple sex partners," he said.

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