You may have cleaned up your act, but if you experimented with drugs in the past, you could be infected with hepatitis C.As many as 400,000 people in the U.K. may be infected without knowing it, and even more in the U.S., because there can be a 20 year delay between the infection and the symptoms. You could be in danger not only if you’ve ever injected drugs, but if you’ve used straws to sniff cocaine too.

It can also be transmitted sexually or through tattooing and piercing. The first signs of the disease include fatigue and aching joints. 80% of people with hepatitis C will develop a chronic infection in the liver, and about one-fifth of these will develop serious liver disease.

In the Observer, Jo Revill quotes Charles Gore, of the Hepatitis C Trust, who says, “How do you reach the man on the street, who might have had a blood transfusion 20 years ago, or who might have injected drugs in his youth, and warn him that he could be wandering around with this virus? It is hard to get people to admit that they might be at risk. It involves them owning up to their past.”

Howard Thomas, of the Department of Health, says, “Many of those infected will be people in influential positions who dabbled with drugs years ago while at college.”

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