In the summer of 1982 in her hometown of Columbia, S.C., Terry Carruth donated her blood--and her life changed forever.
Routine screening at the blood bank revealed that the dental hygienist, then 32, was a carrier of the severe and at times deadly viral liver infection hepatitis B--for which there is no cure.
She lost her job of 13 years and isolated herself for fear of infecting her patients, family and friends. Alone and terrified, she tried to come to grips with the bleak prognosis that she faced 233 times the normal risk of developing cirrhosis or cancer of the liver.
"I was stunned. I had no symptoms and no idea I was infected, as is often the case with carriers," she said. "I was very careful and always asked patients if they ever had hepatitis B. It never occurred to me I would get the disease."
Source Is Unknown
The unknown patient who infected her, she is convinced, had no idea of the danger he or she was posing to others.
"I may have had a tiny cut on my finger or pricked my finger with an instrument, making it very easy for the carrier's saliva to enter the cut and pass on the infection," she said in an interview in San Francisco during a stop on her nationwide tour to tout a vaccine that could have spared her.
"Since there is nothing I can do for myself, I decided to try to help others. That's why I'm willing to share my private and painful story. If only I had been vaccinated."
A former president of the Greater Columbia Dental Hygienists' Society and member of the South Carolina Dental Hygienists' Assn. Executive Board, Carruth said she was heartbroken by having to give up her career.
No Other Skills
"I was educated specifically as a dental hygienist and have no other salable skills," she said.
Now she works part time in a department store.
The infection has shattered her personal life as well. Never married, Carruth said she lives in constant fear of inadvertently infecting family members, close friends or their children.
"Now that I know firsthand how severely hepatitis B can affect your personal and professional life, I would urge everyone in high-risk groups to take advantage of the available protection," she said.
Carruth hopes to attend night school and get a better job, but most of her energies for the last year have been spent crusading around the country for the vaccine, which has the stamp of approval from the Centers for Disease Control in Atlanta, the American Medical Assn. and other medical groups.
Carruth is one of about 800,000 carriers of hepatitis B, the most serious form of hepatitis, which can cause liver damage and even death, according to CDC officials.
About 200,000 Americans develop chronic hepatitis each year, and another 4,000 die annually from the disease and related complications.
The virus is passed through contact with body fluids, like blood and saliva.
Health care professionals who come in contact with blood and blood products face the greatest risk of infection, CDC officials said.
These include dental hygienists, dentists, nurses, laboratory technicians, medical and dental students, surgeons, labor and delivery room personnel and paramedics.
Other High Risk Groups
Others at high risk include homosexuals, prostitutes, certain ethnic communities such as Alaskan Eskimos and Indochinese refugees, intravenous drug abusers, patients who require frequent blood transfusions and residents and staff of institutions for the mentally handicapped.
The CDC, AMA, American Dental Assn., among others, have recommended the vaccine for those at high risk. The California Medical Assn. has called for free vaccination in all medical schools in the state.
The vaccine--available since August, 1982, and shown to be 95% effective in preventing infection for up to five years--has no reported serious side effects.
Total Dosage Costs $100
Because it requires nearly a year of testing for each batch, the vaccine costs about $100 for the three doses required to confer immunity.
Once a person contracts hepatitis B, it is too late. An acute attack is debilitating--producing anorexia, nausea, vomiting, fatigue and liver damage. Recovery can take as long as six months. Kidney failure and death may result.
"The good news is that unlike cancer or heart attacks, this is something people can do something about," Carruth said. "I just want them to know that so they don't wind up like me."