A multi-county outbreak of Hepatitis A remains ongoing with the Kentucky Department for Public Health (DPH) now reporting 117 cases, most of which have occurred in the Jefferson County/Louisville area.
According to DPH, 96 of the cases were reported in Jefferson County. Outbreak-associated cases were also found in Boyd, Bullitt, Carter, Hopkins, Leslie, Marion, McCracken, and Taylor counties. DPH first reported the outbreak on Nov. 21, 2017. No deaths have been attributed to the outbreak in Kentucky.
The 10-year average number of acute hepatitis A cases has been approximately 20 cases per year in the Commonwealth.
Laboratory specimens for some cases have been sent for specialized genetic testing of the hepatitis A virus at the Centers of Disease Control and Prevention (CDC) in Atlanta to determine if Kentucky’s cases are associated with outbreaks in other states. To date, 38 cases from 45 specimens submitted to CDC genetically match outbreaks in San Diego, California and Salt Lake City, Utah.
Similar to hepatitis A outbreaks in other states, the primary risk factors for Kentucky cases have been illicit drug use and homelessness. A single source of infection has not been identified, and transmission is believed to be occurring through person-to-person contact.
People are at increased risk for hepatitis A if they have traveled to a country where the virus is common, are homeless or lack access to adequate bathing and restroom facilities, use illicit drugs, are men who have sex with other men, are any individual with sexual contact with someone who has hepatitis A, have a clotting disorder such as hemophilia, or are household members or caregivers of a person infected with hepatitis A.
Hepatitis A vaccine has been routinely recommended for children in Kentucky aged 12 through 23 months since 2006. The Kentucky Department for Public Health has also recommended catch-up immunizations to prevent hepatitis A for children aged 2 through 18 years. Children in public and private schools in Kentucky will need to have received immunization with hepatitis A vaccine before starting school on or after July 1, 2018. Hepatitis A vaccine is also recommended for adults at increased risk and for any adult who wants to be protected from acute hepatitis A virus infections.
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.
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.
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.
Additional information about hepatitis A can be found from the CDC at https://www.cdc.gov/hepatitis/hav/index.htm
