The Kentucky Department for Public Health (DPH) has declared an outbreak of acute hepatitis A with cases in multiple counties in Kentucky.
In total, 31 cases of acute (rapid onset with symptoms of illness) Hepatitis A have been reported throughout Kentucky in 2017, a 50 percent increase above the average of 20 cases per year reported over the past 10 years. Jefferson County has had 19 confirmed cases, most of which have occurred since August. Cases have been reported in Jefferson, Shelby, Bullitt, Hardin, Henry, Anderson, Mason, Christian, Madison, Fayette, McCracken, Hopkins, and Leslie counties.
DPH, the Louisville Metro Department of Public Health and Wellness (LMPHW), and other health departments have been working to stop the spread of Hepatitis A in the region. Common risk factors of homelessness or drug use have been identified among 12 of the cases in Jefferson County. No deaths have been attributed to this outbreak.
“Acute hepatitis A is a serious and potentially life-threatening infectious disease,” said Dr. Jonathan Ballard, State Epidemiologist for KDPH. “We are working to identify anyone who has been exposed to cases associated with this outbreak and urging those experiencing symptoms of the illness to contact their healthcare provider for appropriate evaluation and medical treatment, if necessary.”
Public Health staff have conducted enhanced surveillance for acute hepatitis A cases, investigated each new case in a county to identify risk factors and close contacts, and recommended postexposure prophylaxis for susceptible close contacts. In addition, laboratory specimens from recently diagnosed cases have been sent for specialized genetic testing of the hepatitis A virus at the Centers of Disease Control and Prevention (CDC) in Atlanta.
Thus far test results match the genotype associated with an acute Hepatitis A outbreaks in California.
“Hepatitis A is a vaccine-preventable illness. All children, aged 1 year through 18 years, are recommended to get the Hepatitis A vaccine as well as adults with increased risk factors or certain medical conditions,” said Dr. Ballard. “DPH is working with the LMPHW and other local health departments to develop an emergency vaccine distribution plan for the area most impacted by the outbreak.”
Increased risk factors include homelessness; all forms of substance use disorder; people with direct contact with someone who has Hepatitis A; travelers to countries where hepatitis A is common; men who have sexual contact with men; household members or caregivers of a recent adoptee from countries where hepatitis A is common; people with clotting factor disorders, such as hemophilia.
In addition, DPH is activating the State Health Operations Center (SHOC) to Level 3 to help coordinate the public health response.
Other than age-appropriate vaccinations, the best way to keep from getting Hepatitis A is to wash your hands using warm water and soap, to handle uncooked food appropriately and to fully cook food. Always wash your hands before touching or eating food, after using the toilet and after changing a diaper. When soap and water are not available, use alcohol-based disposable hand wipes or gel sanitizers.
Signs and symptoms of Hepatitis A include jaundice (yellowing of the skin or eyes), dark-colored urine, fatigue, abdominal pain, loss of appetite, nausea, diarrhea and fever. The virus is found in the stool of people infected with Hepatitis A and is usually spread from person to person by putting something in the mouth (even though it might look clean) that has been contaminated with the stool of a person infected with Hepatitis A. It is often transmitted when people do not wash their hands properly or by eating uncooked or undercooked food.
Not everyone with the acute Hepatitis A virus infection will develop symptoms, however, if symptoms do develop, they may include fever, jaundice or yellowing of the skin, vomiting, fatigue, and grey-colored stools. Persons with symptoms should seek medical care for prompt diagnosis and treatment.
Additional information about Hepatitis A is available from the CDC.