As the country continues to contend with a hepatitis C virus (HCV) epidemic, some states appear to be fighting the virus better than others. One state still in the throes of combating its crisis is Washington––which recently reported an increase in acute and chronic cases of the virus. A recent article in The Seattle Times asks why.

According to data from the Washington State Department of Health, the number of chronic hepatitis C cases increased by 60% across the state between 2009 and 2017 and by 77% in  King County, which includes Seattle. Acute cases of HCV are also on the rise, more than doubling in King County and tripling statewide since 2009. On a more positive note, King County recently reported a slight drop in chronic HCV cases over the past year; the state has not yet published its 2018 numbers.

Experts say the reason for the drop in the number of chronic cases in King County between 2017 and 2018 is unclear; however, many wager that the overall upward trend in new infections over the past decade is likely the result of better screening for and reporting of HCV. What’s more, since about eight in 10 acute cases of hepatitis C develop into chronic cases, health officials say it’s important to look at acute cases to see where the epidemic is headed.

As elsewhere in the country, Washington’s epidemic appears to be most prevalent among baby boomers (those born between 1945 and 1965), who make up the majority of cases, and intravenous drug users, who are currently facing the fastest-growing rate of new infections.

Fortunately, for people diagnosed with HCV today, next-generation direct-acting antiviral treatments boast a success rate of nearly 99% after eight to 12 weeks of treatment. Washington is also one of a growing number of states that covers hepatitis C treatment under its Medicaid program without tight restrictions, thanks to a battle won by advocates in federal court in 2016.

Moving forward, the state’s Health Care Authority says it will work with the department of health and other agencies to eliminate the virus by 2030.