An estimated 57-thousand Iowans suffer from a “silent epidemic” according to doctors who gathered Thursday to discuss Hepatitis “C” and how often the disease goes undetected. Candace Jackson said she found out during a routine physical in 1991 that she had the disease, though her only risk factor had been working as a nurse, since 1972. Jackson says there are almost no symptoms except tiredness, right up till a patient starts to develop liver disease or cirrhosis, and a person unaware he or she has hepatitis can unwittingly pass it on to others. Jackson says it’s not just infecting a friend or family member that concerns her, it’s the risk to the medical community working with patients like her. Jackson says when she’s at a clinic getting tests or having blood drawn, she often has to remind the workers to use protective measures to keep themselves safe. Dr Bret McFarland says as an internist at Broadlawns Medical Center, an inner-city hospital in Des Moines, he sees plenty of hepatitis “C” cases, but a rural doctor may not, and also may lack information about the new treatments available. The doctor says as recently as half-a-dozen years ago treatment options were few and ineffective and doctors would tell patients not much can be done, but now he says they can do much better. Dr McFarland says Hepatitis C isn’t a death sentence, and only one in five oatients will get a permanent condition like cirrhosis of the liver. Risk factors for Hepatitis “C” include I-V drug use, contact with blood in the workplace or military, and even tattoos and piercings.