The North West annual hepatitis C report published today reveals at least 40,000 adults in the region are estimated to be infected.

Statistics show that in the Merseyside area, Wirral has the second largest number of infected people at 1,656. Liverpool has the highest level, with 3,326.

The overall figure of 40,000 is likely to be an underestimate as hepatitis C can be a “silent disease” with some people being infected for a long time without symptoms.

This means many more may have the disease than have been diagnosed so far.

Scientific predictions suggest significant future infection problems, which will have an impact of the NHS. An estimated £29m is being spent currently in the region treating patients with chronic hepatitis C.

Those most at risk of contracting the disease in the North West are people who inject drugs or have injected drugs in the past, and share injecting equipment.

They are likely to be at increased risk even if they injected only once or twice in the past.

Dr Evdokia Dardamissis, consultant in health protection, said: “Hepatitis C remains a major public health problem and one that we are actively addressing in partnership with the NHS and drug services.

“We are working closely with our partners to improve surveillance and research and to increase public awareness, particularly among injecting drug-users because they are at greatest risk in this region.

“If we can raise public awareness, the people who are most at risk can take measures to prevent themselves from becoming infected and those who are already infected can be brought into highly effective treatment programmes.

“An important message is that people who believe they may have been exposed to hepatitis C infection should arrange to be tested for the virus.”

Tests can be arranged through GPs or drug services.

Simple measures such as using sterile injecting equipment and not sharing personal items like toothbrushes and razors will minimise chances of being exposed to hepatitis C.

The NHS Choices website says that in most cases, hepatitis C causes no noticeable symptoms until the liver has been significantly damaged.

When symptoms do occur, they are often vague and can be easily mistaken for another condition.

Symptoms are a high temperature and loss of appetite similar to suffering flu, feeling tired all the time and depression.