Hepatitis A Watch

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A new case of hepatitis A has been diagnosed in a Frankfort food worker, the Franklin County Health Department reports.

The infected individual worked at the KFC located on at 1229 US 127 between Oct. 22 and Oct. 25.

The health department wants to remind the public that it’s rare for restaurant patrons to become infected with hepatitis A virus due to an infected food handler. However, for anyone who consumed food or drink at that KFC location during that time should receive a vaccination by Nov. 8.

Vaccinations are being administered at the Franklin County Health Department located at 100 Glenns Creek Road on the following dates and times:

Monday-Tuesday: 8 a.m. to 11 a.m., 1:30 p.m. to 3:15 p.m.
Wednesday: 8 a.m. to 11 a.m., 1:30 p.m. to 5:15 p.m.
Thursday-Friday: 8 a.m. to 11 a.m.

Anyone who ate there during that time frame should monitor their health for symptoms up to 50 days after exposure.

Careful hand washing, including under the fingernails, with soap and water, along with vaccination of anyone at risk of infection, will prevent the spread of this disease.

Northeast Arkansas continues to have an ongoing hepatitis A (hep A) outbreak. Hep A is a contagious liver disease that can be prevented by a vaccination. The ADH is warning of a possible hep A exposure after an employee of Arkansas State University (ASU) food service and volunteer at Salvation Army has tested positive for the virus.

Anyone who ate at the ASU Student Center or the Salvation Army at 800 Cate Avenue in Jonesboro from Oct. 13 to Oct. 24 should seek vaccination immediately if they have never been vaccinated against hep A or are unsure of their vaccination status. There are no specific treatments once a person gets hep A. Illness can be prevented even after exposure by getting the vaccine or medicine called immune globulin. This medicine contains antibodies to hep A and works best if given within two weeks of exposure to the virus.

Vaccine will be available Thursday Oct. 25 and Friday Oct. 26 from 8 a.m. to 4:30 p.m. at the Craighead County Local Health Unit in Jonesboro at 611 E. Washington Ave. Vaccine will also be available at the ASU Reng Student Center (3rd floor River Rooms) located at Aggie Circle on campus in Jonesboro from 8 a.m. to 5 p.m. on Monday, Oct. 29 and Tuesday, Oct. 30. The vaccine will be provided to the public at no cost. People should bring their insurance card and driver’s license if they have one. Students who will are unable to attend the clinics listed above because they are traveling for the weekend may be able to visit a Local Health Unit in another county. Those visiting Local Health Units in other counties should call ahead to ensure vaccine is available. Local Health Unit listing can be found at https://www.healthy.arkansas.gov/health-units.

Anyone experiencing symptoms should seek care immediately. Typical symptoms of hep A include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain, or jaundice (yellowing of the skin or eyes). It can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months.

Risk of getting hep A in a food service setting is low. Restaurants must follow ADH protocols for handwashing and glove use, and employees are not to return to work until they are no longer sick. Hep A is being spread in this outbreak primarily through close contacts in the community, not through eating at restaurants.

Since February, 178 cases of hep A have been reported as part of an outbreak in Northeast Arkansas, including one death. Greene County has had the most cases, although there have been cases in Arkansas, Clay, Cleburne, Craighead, Independence, Lawrence, Lee, Mississippi, Monroe, Phillips, Poinsett, and Randolph counties.

High priority groups for getting the hep A vaccine include:

  • Anyone who has had close contact with someone who has hep A
  • Food workers
  • People who use drugs, whether injected or not
  • People experiencing homelessness, transient, or unstable housing
  • People who have been recently incarcerated

The hep A vaccine is safe and effective. Hep A is a contagious liver disease that results from infection with the hep A virus, which is a different virus from the viruses that cause hep B or hep C. It is usually spread when a person ingests tiny amounts of fecal matter from contact with objects, food or drinks contaminated by the feces (stool) of an infected person.

A person can transmit the virus to others up to two weeks before and one week after symptoms appear. If infected, most people will develop symptoms three to four weeks after exposure; however, the virus can cause illness anytime from two to seven weeks after exposure. Many people, especially children, may have no symptoms. Almost all people who get hep A recover completely and do not have any lasting liver damage, although they may feel sick for months.

Older people typically have more severe symptoms. Other risk factors for having more severe symptoms of hep A include having other infections or chronic diseases like hep B or hep C, HIV/AIDS, or diabetes. Up to one in three adults are typically hospitalized. Death due to hep A is rare, but is more likely in patients with other liver diseases (like hep B or hep C).

Northeast Arkansas continues to have an ongoing hepatitis A (hep A) outbreak. Hep A is a contagious liver disease that can be prevented by a vaccination. The ADH is warning of a possible hep A exposure after an employee of Murdocks Catfish, located at 2612 Red Wolf Blvd in Jonesboro, tested positive for the virus.

Anyone who ate food from this restaurant from Sept. 27 to Oct. 5 should seek vaccination immediately if they have never been vaccinated against hep A or are unsure of their vaccination status. There are no specific treatments once a person gets hep A. Illness can be prevented even after exposure by getting the vaccine or medicine called immune globulin. This medicine contains antibodies to hep A and works best if given within two weeks of exposure to the virus.

“This restaurant worked proactively with the ADH by requiring vaccination for all of their employees with complete compliance prior to this potential exposure,” said Dr. Dirk Haselow, State Epidemiologist. “ADH is not aware of any ongoing risk in this restaurant at this time.”

Vaccine will be available at the Craighead County Local Health Unit located at 611 E. Washington St. in Jonesboro from 8 a.m. to 6 p.m. Thursday, October 11, and at the Earl Bell Community Center located at 1212 S. Church St. in Jonesboro from 8 a.m. to 6 p.m. Friday, October 12.  The vaccine will be provided to the public at no cost. People should bring their insurance card and driver’s license if they have one.

Anyone experiencing symptoms should seek care immediately. Typical symptoms of hep A include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain, or jaundice (yellowing of the skin or eyes). It can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months.

Risk of getting hep A in a restaurant setting is low. Restaurants must follow ADH protocols for handwashing and glove use, and employees are not to return to work until they are no longer sick. Hep A is being spread in this outbreak primarily through close contacts in the community, not through eating at restaurants.

Since February, 158 cases of hep A have been reported as part of an outbreak in Northeast Arkansas, including one death. Greene County has had the most cases, although there have been cases in Clay, Craighead, Independence, Lawrence, Lee, Mississippi, Monroe, Phillips, Poinsett, Arkansas, and Randolph counties.

The ADH continues to encourage all Greene County residents who are age 19 to 60 to get vaccinated for hep A and wash their hands thoroughly and often. The ADH strongly encourages all food handlers to be vaccinated against hep A in Greene, Clay, and Craighead counties to protect against spread of the virus.

High priority groups for getting the hep A vaccine include:

  • Anyone who has had close contact with someone who has hep A
  • Food workers
  • People who use drugs, whether injected or not
  • People experiencing homelessness, transient, or unstable housing
  • People who have been recently incarcerated

The hep A vaccine is safe and effective. Hep A is a contagious liver disease that results from infection with the hep A virus, which is a different virus from the viruses that cause hep B or hep C. It is usually spread when a person ingests tiny amounts of fecal matter from contact with objects, food or drinks contaminated by the feces (stool) of an infected person.

A person can transmit the virus to others up to two weeks before and one week after symptoms appear. If infected, most people will develop symptoms three to four weeks after exposure; however, the virus can cause illness anytime from two to seven weeks after exposure. Many people, especially children, may have no symptoms. Almost all people who get hep A recover completely and do not have any lasting liver damage, although they may feel sick for months.

Older people typically have more severe symptoms. Other risk factors for having more severe symptoms of hep A include having other infections or chronic diseases like hep B or hep C, HIV/AIDS, or diabetes. Up to one in three adults are typically hospitalized. Death due to hep A is rare, but is more likely in patients with other liver diseases (like hep B or hep C).

Since November 2017, the Indiana State Department of Health (ISDH) has been investigating an outbreak of acute hepatitis A virus (HAV). Cases have been infected with HAV strains genetically linked to outbreaks across the United States. Indiana has an average of 20 cases of hepatitis A per 12 month period.

Indiana is one of serveral states experiencing a hepatitis A outbreak, and outbreak-related cases have been confirmed across the state. Information on other outbreaks can be accessed from the Centers for Disease Control and Prevention (CDC) website. Transmission is presumed to occur person to person; no contaminated commercial food product has been identified. Based on CDC guidelines, populations who are homeless, transient, incarcerated or use illicit drugs and their close direct contacts are considered at increased risk of exposure to hepatitis A.

If you believe you have been exposed to hepatitis A or are homeless, use injection or non-injection drugs, were recently incarcerated, or had contact with someone who has hepatitis A, contact your healthcare provider about hepatitis A vaccine.

To reduce the risk of hepatitis A transmission, people who have not received two doses of hepatitis A vaccine may ask their healthcare providers for protection. Additionally, always wash your hands with soap and water after going to the bathroom, after changing diapers and before preparing meals for yourself and others. Do not attend work or school if you are experiencing symptoms of hepatitis A, which include nausea, vomiting, diarrhea, loss of appetite, tiredness, stomach ache, fever, dark-colored (cola) urine, light-colored stool and jaundice (yellowing of skin and eyes). Symptoms may take as many as 50 days from exposure to appear.

According to press reports, Arkansans state health officials are urging all food service workers in Clay County, as well as people who recently ate at one gas station in particular, to get vaccinated against hepatitis A amid an outbreak that has infected a dozen Arkansans since February.

The latest food service worker to be infected was an employee of a Subway and Flash Market gas station at 105 N. Missouri Ave. in Corning. People who ate at the business between March 30 and Tuesday should seek care immediately if they haven’t been vaccinated, the state Department of Health said in a news release.

In Indiana, health officials in Floyd County say a case of Hepatitis A has been confirmed in a food service employee.

The Floyd County Health Department says the person works at the Taco Bell located at 900 Lafollette Center in Floyds Knobs. That restaurant is about a mile north of Interstate 64 on U.S. 150. Anyone who has eaten at the restaurant between April 1 and April 18 should get the Hepatitis A vaccine before April 30 to reduce the chance of infection.

Hepatitis A is a viral infection of the liver and is highly contagious.  People become infected through contact with:

  • Shared syringes used to inject drugs
  • Foods prepared or served by infected persons
  • Stool or blood of infected persons
  • Inanimate objects that may have trace amounts of fecal material from hand contact.

The symptoms, which can vary greatly from severe to none at all, may include:

  • Loss of appetite
  • Nausea
  • Tiredness
  • Fever
  • Stomach ache
  • Dark (cola) colored urine
  • Light colored stools.

Jaundice, the yellowing of the eyes or skin, may appear a few days after the onset of symptoms.

Persons can become ill 15-50 days after being exposed to the Hepatitis A virus. Most people feel sick for several weeks, but they usually recover completely and do not have lasting liver damage.

Since January 1, 2017, Utah public health has identified 233 confirmed cases of hepatitis A virus (HAV) infection; many among persons who are homeless and/or using illicit drugs. Several cases have been linked by investigation and/or viral sequencing to a national outbreak of hepatitis A involving cases in California and Arizona. Hospitalization rates of less than 40% have been described in previous hepatitis A outbreaks; however, other jurisdictions associated with this outbreak are reporting case hospitalization rates approaching 70%. The high rate of hospitalization may be a result of cases having underlying illnesses (e.g., alcoholism), or a higher rate of hepatitis comorbidities (e.g., hepatitis B or C). In response to the outbreak, public health officials have been working to identify cases and contacts, provide education, and ensure opportunities for vaccination of close contacts to cases and vulnerable populations.

Hepatitis A is usually spread through having oral contact with items contaminated with hepatitis A, for example, through ingesting food or drinks contaminated by infected feces. Some people do not develop symptoms, even if infected. If symptoms occur, they usually appear anywhere from 2-6 weeks after exposure. Symptoms usually develop over a period of several days, and may include jaundice (the yellowing of the skin or whites of the eyes), abdominal pain, nausea or diarrhea. Hepatitis A vaccination is the best way to prevent hepatitis A infection.

Last updated 04/09/18

Outbreak-Associated Cases 217
2017 149
2018   68
Deaths – 2 in Salt Lake City

Public health officials and the Michigan Department of Health and Human Services (MDHHS) are continuing to see an elevated number of hepatitis A cases in the state.

Since the beginning of the outbreak in August 2016, public health response has included increased healthcare awareness efforts, public notification and education, and outreach with vaccination clinics for high-risk populations. No common sources of food, beverages, or drugs have been identified as a potential source of infection. Transmission appears to be through direct person-to-person spread and illicit drug use. Those with history of injection and non-injection drug use, homelessness or transient housing, and incarceration are thought to be at greater risk in this outbreak setting. Notably, this outbreak has had a high hospitalization rate.

Michigan Hepatitis A Outbreak Cases and Deaths as of April 4, 2018

Cases Hospitalizations Deaths
802 644 (80.4%) 25 (3.1%)

 

 Confirmed Cases Referred August 1, 2016-April 4, 2018 
Meeting the MI Hepatitis A Outbreak Case Definition
 County (or city) Total Cases  County (or city) Total Cases
 Macomb 216  Sanilac 6
 City of Detroit 167  Lapeer 6
 Wayne 138  Livingston 6
 Oakland 108  Grand Traverse 4
 St. Clair 30  Allegan 1
 Ingham 24  Clare 1
 Washtenaw 17  Hillsdale 1
 Monroe 17  Huron 1
 Genesee 13  Ionia 1
 Isabella 8  Kent 1
 Calhoun 7  Leelanau 1
 Shiawassee 7  Lenawee 1
 Eaton 5  Newaygo 1
 Clinton 3  Schoolcraft 1
 Gratiot 3  Van Buren 1
 Saginaw 3  Other* 1
 Mecosta 2

 *Jackson Michigan Department of Corrections

 

 

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.