Since Jan. 1, 2017, the Kentucky Department for Public Health (KDPH) has identified 148 confirmed cases of acute hepatitis A, a liver disease caused by hepatitis A virus. An increase in cases since Aug. 1, 2017, primarily among the homeless and drug users, prompted declaration of a statewide outbreak in Nov. 2017. Viral sequencing has linked several outbreak-associated cases in Kentucky with outbreaks in California and Utah.

KDPH is working closely with the Centers for Disease Control and Prevention and local health departments to provide guidance and education to health professionals and at-risk populations. Treatment for acute hepatitis A generally involves supportive care, with specific complications treated as appropriate. Hepatitis A is a vaccine-preventable disease.

Counts as of Mar. 3, 2018

§  Total Outbreak: 148

§  Hospitalizations: 107

§  Deaths: 1

New cases the week of Feb. 25 – Mar. 3: 23

Since Jan. 1, 2017, the Kentucky Department for Public Health (KDPH) has identified 103 confirmed cases of acute hepatitis A, a liver disease caused by hepatitis A virus. An increase in cases since Aug. 1, 2017, primarily among the homeless and drug users, prompted declaration of a statewide outbreak in Nov. 2017. Viral sequencing has linked several outbreak-associated cases in Kentucky with outbreaks in California and Utah.

KDPH is working closely with the Centers for Disease Control and Prevention and local health departments to provide guidance and education to health professionals and at-risk populations. Treatment for acute hepatitis A generally involves supportive care, with specific complications treated as appropriate. Hepatitis A is a vaccine-preventable disease.

There has been a confirmed case of hepatitis A in Eaton County, the Barry-Eaton District Health Department announced Wednesday.

The health department says the individual is being treated and is not at high risk of spreading the disease.

It is the first known hepatitis A case in Eaton County this year, but it is not yet known whether the case is connected to a more widespread outbreak in southeastern Michigan, the Barry-Eaton health department said.

A Detroit Free Press analysis determined Michigan had the highest per capita rate of hepatitis A cases among U.S. states, with more than 500 Michigan cases reported in 2017. Most of those cases occurred in Detroit and Macomb County.

In San Diego California, the county Health and Human Services Agency published new weekly totals, which add one to the number of deaths recorded since the health crisis started in November 2016. The running tally of confirmed cases also continues to increase, reaching 536 from a previous total of 516 – including 20 deaths. On September 15th the county notified the public that a worker at World Famous restaurant in Pacific Beach had tested positive.

In Michigan, since August 2016, there have been 457 confirmed cases of hepatitis A – including 18 deaths. These have occurred in Huron, Ingham, Lapeer, Livingston, Macomb, Monroe, Oakland, Sanilac, St. Clair, Washtenaw, and Wayne counties. Of the confirmed cases, 85 percent of patients were hospitalized. On October 30th, Little Caesars Pizza store and Firewater Bar and Grill employees were implicated.  Cardamom restaurant was implicated on October 5th.

The Wayne County Department of Health, Veterans and Community Wellness is investigating cases of Hepatitis A related to two Grosse Pointe restaurants.

The restaurants are Uncle Paul’s Pizza on Mack Ave. and Cabbage Patch Cafe and Catering on Kercheval Avenue.

Both establishments have voluntarily closed and are working with WCDHVCW during the investigation.

WCDHVCW is advising people who consumed food from these establishments between Aug. 1 and Sept. 29, 2017 to watch for symptoms of Hepatitis A which can include abdominal pain, nausea, vomiting, diarrhea, dark urine, clay colored stool, fever, chills, yellow skin and eyes (jaundice).

Symptoms occur between 15 and 50 days after exposure and can last for several weeks to months.

Public Health Announces Hepatitis A Outbreak in LA County  – Hepatitis A vaccine is the best protection

The Los Angeles County Department of Public Health (Public Health) has declared a local outbreak of hepatitis A (HAV) in Los Angeles County because the most recent new cases appear to be locally acquired.Hepatitis A outbreaks are currently ongoing in San Diego and Santa Cruz counties. The large majority of cases have occurred in persons who are homeless and/or use illicit drugs (injection and non-injection), with several cases also occurring among people who provide services to the homeless.

Public Health has confirmed 10 total cases of hepatitis A among high-risk individuals (those that are homeless or in institutions that serve the homeless) in Los Angeles County. Of the confirmed cases, four had been in San Diego and one had been in Santa Cruz during their exposure period. Three secondary cases occurred in a health care facility in Los Angeles County. The two most recent cases appear to have acquired their infection locally within Los Angeles County.

“Public Health has been proactively preparing for an outbreak for some time and is working diligently to prevent spread in local communities. Our priorities are to keep all our residents both safe and well informed of the situation,” said Jeffrey Gunzenhauser, MD, MPH, Interim Health Officer, Los Angeles County. “Vaccination is the best protection against Hepatitis A. With this in mind, our outreach teams and clinics are offering free vaccine to persons who are homeless, active drug users, and those who provide services and support to those individuals.”

A person can get hepatitis A if they come into contact with an infected person’s feces through contaminated food or objects. The hepatitis A virus can spread when a person does not properly wash their hands after going to the bathroom or changing diapers. Other modes of transmission include certain sexual practices, sharing equipment related to illicit drug use, and consumption of food or water contaminated with the virus. People who are homeless are at higher risk because they face challenges to maintaining good hygiene.

Physicians are required to report HAV cases to Public Health. HAV causes acute liver disease, which may be severe. It is transmitted by contact with feces from a person who is infected – often through contact with food or water or during sex or other close contact. Signs and symptoms of acute HAV include fever, malaise, dark urine, lack of appetite, nausea, and stomach pain, followed by jaundice. Symptoms generally last for less than 2 months although some persons may have prolonged or more severe illness. Infection can be prevented in close contacts of patients by vaccination or administration of immune globulin within 2-weeks following exposure. If you experience these symptoms, contact your physician.

Although Hepatitis A is very contagious, you can take the following steps to prevent Hepatitis A:

  • Get vaccinated for Hepatitis A
  • Don’t have sex with someone who has Hepatitis A infection
  • Use your own towels, toothbrushes and eating utensils
  • Don’t share food, drinks, or smokes with other people
  • Wash hands with soap and water after using the bathroom, changing diapers, and before preparing, serving or eating food.

Public Health continues surveillance for cases and is working closely with healthcare providers and organizations that serve the homeless population to protect the health of patients/clients, staff and the community. Public Health is providing education and vaccination to the homeless and those who work with them, and working with other organizations that provide services for the homeless population to reach this community. Hepatitis A vaccination is available at Public Health clinics or from your health care provider. County residents may call the LA County Information line at 2-1- 1 from any landline or cell phone within the county for referrals to providers offering vaccines at no-cost or a reduced cost. For patients without access to HAV vaccine, Public Health will have vaccine available at its Public Health Centers located throughout the County.

The death toll in an outbreak of hepatitis A in San Diego has reached 16, and 421 people have been sickened with the disease, the county Health and Human Services Agency reported Today. The figures are associated with an outbreak that began last November and has struck the homeless population and users of illicit drugs particularly hard.

Patients who contracted hepatitis A, which attacks the liver, in a manner unrelated to the outbreak aren’t included in the statistics.

The new numbers were released the same day the city of San Diego began a pilot program to keep 14 public restrooms in Balboa Park open 24 hours a day. Under direction from county health, the city on Monday began washing down streets and sidewalks in the East Village with a bleach formula.

Also, around 40 hand-washing stations were set up around the city — concentrated in areas where the homeless congregate — around the beginning of the Labor Day weekend.

County officials, meanwhile, are continuing a program of vaccinations, which are considered to be the best way to prevent hepatitis A. The disease is spread by contact with microscopic amounts of infected feces and via sexual transmission.

More than 7,000 shots have been given to people considered to be at-risk of acquiring the disease, and over 19,000 shots given out in total.

In January’s annual tally of the area’s transient population, 5,619 homeless individuals were counted in the city of San Diego, a 10.3 percent increase from last year. Of those, 3,231 were living on the streets.

Oakland County Health Division reports eight new cases of Hepatitis A in the last week associated primarily with the Farmington Hills area. The Health Division has not yet identified a source, but is investigating potential common factors such as contaminated food, sick individuals, travel, and healthcare exposure.

“These new cases serve as a vital reminder of why it is critical to get vaccinated,” said Leigh-Anne Stafford, health officer for Oakland County. “The Health Division urges all residents, food handlers, and healthcare providers to get the Hepatitis A vaccine and to wash hands thoroughly. Ill food workers and health care workers are encouraged to stay home from work, seek medical attention, and report their illness to their employer.”

Dr. Pamela Hackert, medical director for Oakland County Health Division said, “The virus is shed in feces and is most commonly spread from person to person by contaminated hands. In addition to vaccination, good hygiene, proper sanitation of surfaces, and proper food preparation are keys in preventing this contagious disease.”

Hepatitis A is an infection of the liver caused by a virus and is a vaccine-preventable disease. Symptoms of Hepatitis A include sudden abdominal pain, fatigue, diarrhea, nausea, headache, dark urine, and vomiting followed by yellowing of the skin and eyes. Symptoms may appear from two to six weeks after exposure, with the average time being about one month. In rare cases, those with a pre-existing severe illness or a compromised immune system can progress to liver failure. Individuals are advised to contact their doctor if they have a sudden onset of any symptoms.

To reduce the risk of contracting Hepatitis A:

  • Wash hands frequently, especially after using the bathroom, changing diapers, and before preparing and eating food. Rub hands vigorously with soap and warm running water for at least 20 seconds. Handwashing is essential and one of the most effective ways to prevent the spread of infection.
  • Clean and disinfect all surface areas if someone in the household or workplace has symptoms, especially areas such as toilets, sinks, trashcans, doorknobs and faucet handles.
  • Do not prepare food if you have symptoms and refrain from food preparation for at least three days
  • after symptoms have ended, or two weeks after onset of clinical symptoms, whichever is longer.
  • Get the Hepatitis A vaccine.

The Hepatitis A vaccine is available through some health providers, CVS Minute Clinics, Oakland County Health Division offices in Southfield and Pontiac, and many pharmacies. Call ahead to ensure your health care provider or pharmacy has the vaccine available.

Health Division offices are located at the following addresses:

  • North Oakland Health Center, 1200 N. Telegraph Road, Building 34 East, Pontiac
  • South Oakland Health Center, 27725 Greenfield Road, Southfield

Payment options include cash and credit card. There is a $5 fee per visit, per client as well as additional fees for credit card payments. Vaccine fees are charged to individuals who are not eligible for federal and/or state programs that cover vaccination costs. The Vaccines for Children (VFC) Program offers vaccines at no cost for eligible children up to 18-years-old. If you have insurance, check with your health care/insurance provider for possible benefit coverage. No one will be denied access to services due to inability to pay. A discounted/sliding fee schedule is available.

For more information about Hepatitis A, visit or call Nurse on Call at 800-848-5533, Monday through Friday, 8:30 a.m. – 5:00 p.m.

From August 1, 2016 to March 21, 2017, 107 cases of lab-confirmed hepatitis A have been reported to public health authorities in these jurisdictions. This represents an eightfold increase during the same time last year. Ages of the cases range from 22 to 86 years, with an average age of 45 years. The majority of the cases have been male. Eighty-five percent of the cases have been hospitalized with two deaths reported.  Approximately one-third of the cases have a history of substance abuse, and 16 percent of all cases are co-infected with hepatitis C. No common sources of infection have been identified.

Hepatitis A is a vaccine-preventable disease. While the hepatitis A vaccine is recommended as part of the routine childhood vaccination schedule, most adults have not been vaccinated and may be susceptible to the hepatitis A virus.

Hepatitis A vaccination is recommended for:

  • All children at age 1 year
  • Close personal contacts (e.g., household, sexual) of hepatitis A patients
  • Users of injection and non-injection illegal drugs
  • Men who have sex with men
  • People with chronic (lifelong) liver diseases, such as hepatitis B or hepatitis C. Persons with chronic liver disease have an elevated risk of death from liver failure
  • People who are treated with clotting-factor concentrates
  • Travelers to countries that have high rates of hepatitis A
  • Family members or caregivers of a recent adoptee from countries where hepatitis A is common

Individuals with hepatitis A are infectious for 2 weeks prior to symptom onset. Symptoms of hepatitis A include jaundice (yellowing of the skin), fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, and light-colored stools. Symptoms usually appear over a number of days and last less than 2 months; however, some people can be ill for as long as 6 months. Hepatitis A can sometimes cause liver failure and death.

Risk factors for a hepatitis A infection include living with someone who has hepatitis A, having sexual contact with someone who has hepatitis A, or sharing injection or non-injection illegal drugs with someone who has hepatitis A. The hepatitis A virus can also be transmitted through contaminated food or water.

333 ill, 11 deaths with 232 hospitalized.

Since early 2017, the Public Health Services Division, in the County of San Diego Health and Human Services Agency, has been investigating a local Hepatitis A outbreak. The majority of people who have contracted hepatitis A are homeless and/or illicit drug users, although some cases have been neither.  The outbreak is being spread person-to-person and through contact with a fecally contaminated environment.  No common sources of food, beverage or drugs have been identified that have contributed to this outbreak, though investigation is ongoing.  

Vaccination efforts are being implemented in targeted locations by County staff and in collaboration with health care partners. Health providers are asked to inform the Epidemiology Program if they have a patient suspected to have the hepatitis A infection, before the patient leaves the emergency department or provider’s office.

In a follow-up on the hepatitis A outbreak in San Diego County, CA, the number of cases reported this year has climbed to 312, including 10 fatalities, according to latest health department data.

Of the cases, nearly seven out of 10 patients required hospitalization for their illness (215).

The County of San Diego Health and Human Services Agency says the investigation into the outbreak is ongoing.

It has been challenging because of the long incubation period of the disease (15 to 50 days) and the difficulty experienced to contact many individuals sickened with the illness who are homeless and/or illicit drug users. To date, no common source of food, beverage, or other cause has been identified; as a result, the source of the outbreak remains undetermined.