By KRISTI L. NELSON, nelsonk@knews.com
July 26, 2005
With 16 cases confirmed in the past month, health officials announced Tuesday that a “community-wide outbreak” of hepatitis A in Campbell County is requiring “intense efforts” to stop the spread.
The confirmation of “several” cases in children is particularly concerning, said Dr. Paul Erwin, director of the East Tennessee Regional Health Office. Children often don’t show symptoms when infected with hepatitis A but can still spread the virus to others. Officials haven’t identified a source for the outbreak.
On Thursday the Campbell County Health Department and ETHRO will give hepatitis A vaccinations to all workers and children 2 and older in Campbell County’s six day-care centers. So far, only one of the confirmed cases is in a day-care worker, Erwin said, “but daycares can be a place where hepatitis A can come in and go out (into the community) very quickly.”

Also, beginning on Friday, parents can bring children ages 2-5 to the Campbell County Health Department to receive the vaccine, which consists of two shots given six months apart, Erwin said. Health officials are focusing on younger children because they’re less likely to show symptoms when infected.
Doctors also can provide the vaccine, which is only known to be effective if someone hasn’t already been infected.
Those who have already been exposed to the virus through contact with infected people can receive immune serum globulin (IsG) from the health department. The IsG shot offers some protection if given within 14 days.
Erwin said some of the cases in this outbreak might be “third-generation” cases from an April outbreak in which 23 people were infected in Campbell, Scott and Jefferson counties. No source was ever found. Erwin said health officials have given more than 400 IsG shots in the Campbell County area since April.
“Despite the intense efforts of the Campbell County Health Department staff, the Regional Office and disease investigators from Nashville to locate a source and control or stop the spread, this has become a widespread issue,” Erwin said. “We’re not talking about a single common source — a restaurant, or a day-care.”
Most recent cases are connected to two extended families, but Erwin said there’s no way to know the extent of the outbreak yet.
“This won’t be stopped immediately, even with ? vaccine,” he said. “It will take many weeks of efforts to make an impact.”
Health officials are asking doctors and residents to watch for symptoms. Although people can be infected a month or more before showing any symptoms, their contacts can often be given IsG.
Above all, Erwin stressed thorough hand-washing after using the bathroom or changing diapers and before preparing or eating food. He also recommended people not share cigarettes, or eat and drink after one another.
“Since hepatitis A can be spread before a person even becomes sick or finds out they have hepatitis A, we may see dozens of cases before this has slowed,” he said. “That is why it is absolutely important for all persons to practice good hygiene every day.”
Kristi L. Nelson may be reached at 865-342-6434.