LAFAYETTE — Nearly all of the needles handed out by the Tippecanoe County Health Department in 2019 were returned to be exchanged for clean syringes.

The department received 94.9 percent of the syringes back in its needle exchange program.

Dr. Jeremy Adler, the county's health officer, spent about 30 minutes presenting 2019 stats for the Gateway to Hope, the county's needle exchange program implemented in August 2017.

The state health department's standard for reporting the rate of returned needles is to compare the number of needles given to Gateway to Hope participants and the needles returned to the program in exchange for new, clean needles, Adler said.

That rate is nearly 95 percent, according to Adler's presentation Wednesday in the Tippecanoe Room at the County Building.

“That return rate includes only syringes from returning participants in the program,” he said. “The state average for that number is 80 percent, so our program has been performing better than the state average.”

Adler explained the controversial needle exchange program.

“It’s a comprehensive harm-reduction program," he said. "It was started as an evidence-based response to a local public health emergency due to a rise of Hepatitis C cases here in our county.”

Reducing drug addicts' use of dirty needles reduces new cases of Hepatitis C and helps to prevent an HIV outbreak, as well as safely disposes of syringes and creates a pathway to treatment and social services for addicts, Adler said.

Tippecanoe County reported 54 new Hepatitis C cases in 2013, but by 2017 when the program was started, the new cases rose to 176.

In 2018 — Gateway to Hope's first full year — new Hepatitis C cases dropped by 135, but in 2019, the number of new Hep C cases increased to 158.

“This year it has gone up a little bit," Adler said, "but we believe part of that reason of that increasing is that starting in 2019 and going into the county jail and testing inmates for Hepatitis C.

“So we’re actually testing a higher-risk population, so we’re finding more cases in individuals who otherwise would not have been tested.”

Of the Gateway to Hope participants, 78 percent have been tested for Hepatitus C and 82 percent of the participants have been tested for HIV.

Tippecanoe County Commissioner Dave Byers asked why all of the Gateway to Hope participants were not tested for the diseases.

Tippecanoe County Health Department Administrator Khala Hochstedler replied, “We don’t test if they come in and say they have Hep C or HIV.

"There are a lot of participants that already know their status when they come in, so there’s no point in wasting that test and that resource because that costs money.”

Adler added, “We can’t require testing as part of participation in the program. It’s recommended, of course.”

The Hep C 2019 cases, while more than 2018, are still fewer than in 2017.

“We think this is a good sign that our program is helping to prevent new cases,” he said.

The Tippecanoe County Commissioners declared a health emergency in 2016 because of the increase in Hep C cases. It was a public health concern based on Scott County, Indiana's, Hep C outbreak in 2010, which spawned an HIV outbreak in 2013.

A medical journal, The Lancet, published a research report on Scott County, Indiana's Hep C outbreak, which was followed by a HIV outbreak because of drug users sharing dirty needles.

The study indicated that if Scott County had a needle-exchange program, far fewer HIV cases would have happened, according to information Adler presented.

“One of the lessons we learned from Scott County is that prior to the HIV outbreak, they had a Hep C outbreak in about 2010, 2011," Adler said. "That’s now known to be a sign of a potential HIV outbreak coming.”

In 2019, Tippecanoe County reported only six new HIV cases.

The county's health department also showed off its brand new mobile unit, which can be used for disease testing, immunizations and in health emergency, as a self-contained, mini clinic, Tippecanoe County Health Department Administrator Khala Hochstedler said.

Additionally, the mobile unit also will be used to distribute needles to participants in Gateway to Hope, she said.

“It’s not going to be the (syringe service program) mobile unit," she said. "It’s the health department mobile unit.

"I don’t want (a) stigma attached to this mobile unit because that’s going to hurt me in an outbreak situation when I’m trying to reach people.

“Yes, it will be used for (syringe service program). … It is the nursing division on wheels.”

Reach Ron Wilkins at 765-420-5231 or at rwilkins@jconline.com. Follow on Twitter: @RonWilkins2.