The Department for Public Health (DPH), within the Cabinet for Health and Family Services (CHFS), is investigating two recent hepatitis A-related deaths in Franklin County.
DPH declared a hepatitis A outbreak last year. Since August of 2017 more than 2,275 outbreak-associated cases of acute hepatitis A have been reported in 94 of Kentucky’s 120 counties. Hepatitis A has been a contributing factor in 16 deaths during this outbreak, including the two most recent deaths in Franklin County.
“The best way to prevent hepatitis A is to get vaccinated,” said Jeffrey Howard, M.D., commissioner of DPH. “The vaccine is effective and has an excellent track record. In addition to vaccination, practicing good hygiene such as washing your hands with soap and warm water helps prevent the spread of this serious disease. Always wash your hands before touching or eating food, after using the toilet and after changing a diaper. Hand sanitizer is not as effective as soap and water against the hepatitis A virus.”
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, fever, and grey-colored stools. Persons with symptoms should seek medical care for prompt diagnosis and treatment. Illness from hepatitis A is typically acute and self-limited; however, when this disease affects populations with already poor health (e.g., hepatitis B and C infections, chronic liver disease), infection can lead to serious outcomes, including death.
The virus is being spread from person-to-person, primarily among people who use injection and non-injection drugs (including marijuana), people who are homeless, and their close direct contacts. Although cases in food handlers occur, food or drinks have not been identified as potential sources of infection in the jurisdictions experiencing hepatitis A outbreaks. Individuals who live in a household with an infected person or who participate in risk behaviors previously described are at greater risk for infection. 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.
Multiple states are experiencing outbreaks of acute hepatitis A. For the current U.S. outbreaks among people reporting drug use and/or homelessness and their contacts, vaccination is recommended. The hepatitis A vaccine, given in two doses six months apart, is available from medical providers, local health departments and many pharmacies. The vaccine is covered by most insurance plans. DPH is piloting programs in multiple emergency departments to encourage the screening and vaccination of those persons at risk for hepatitis A.
Additionally, the Advisory Committee on Immunization Practices (ACIP) recommends routine hepatitis A vaccination of children at one year of age. Per Kentucky Administrative Regulation (902 KAR 2:060,) children must receive the hepatitis A vaccine in order to attend schools or daycare centers.
More information about hepatitis A can be found from the CDC at https://www.cdc.gov/hepatitis/hav/index.htm