On March 26th, Mike Pence, the governor of Indiana, declared a public health emergency. It appeared, as of that date, 81 people had tested positive for HIV. All appeared to be linked to injection drug use. Without the executive order issued, the additional resources and services to curb the outbreak would not have been possible.

It is a growing issue in rural communities, drug abuse. Often due to the unemployment and underemployment rates, the socio-economic make up of a rural community and the lack of drug abuse counseling and other resources, the problem breeds like a bad infection. In this case, that infection is HIV.

Due to the public health emergency, the state of Indiana has implemented a wide scale public education, community outreach and a syringe exchange. There is also support for medical care stemming from the HIV, or potential Hepatitis C cases, which have been identified. And perhaps the most important source to helping prevent this from happening again is the substance abuse treatment and counseling.

In Scott County, IN, this outbreak stemmed from the use of injected opioids. And yes, this county is one which had become quite vulnerable to an episode like this due to the lack of resources. As of May 7th, the number of confirmed cases has risen to 150. Still the health officials remain “cautiously optimistic” and the campaign has extended to truckers and other travelers passing through the state on I-65. The public health emergency has been extended into May.

So what’s next and what have we learned? As with other outbreaks, healthcare or drug related, we see a continued importance of timely HIV and Hep C surveillance. But this may not prevent, just help the spread. That is why better substance abuse treatment and counseling, especially in rural communities, is a necessity. For example, the needle exchange in Indiana is not just about turning in used needles; it is about the questions asked and the counseling given to those in most need.

For more information on Indiana’s “You are not alone” campaign visit www.StateHealth.IN.gov

Simply put, we need to do better. We cannot continue to ignore these smaller communities. And we cannot forget about those struggling in Scott County when this is no longer a news story. Even with lessened injection drug use and community resilience, for those struggling with HIV and their loved ones the fight continues.