UPDATE AS OF November 3, 2018
As of January 1, 2017, the Kentucky Department for Public Health identified 148 confirmed cases of acute hepatitis a. Hepatitis A is a liver disease caused by hepatitis A virus. An increase in cases occurred as of August 1, 2017, primarily among the homeless and persons who use drugs. The increase in cases prompted the declaration of a statewide outbreak in November of 2017. By use of viral sequencing, outbreak-associated Kentucky cases have been linked to ongoing outbreaks in California and Utah.
Total Outbreak Count: 2545
Total Hospitalizations: 1342 (53%)
Deaths: 17 (<1%)
Oldham County Confirmed Hepatitis A Cases: 11
Additional counties outside of Oldham that have been impacted by the outbreak include: Adair, Allen, Anderson, Ballard, Barren, Bell, Boone, Bourbon, Boyd, Boyle, Breathitt, Bullitt, Butler, Campbell, Carlisle, Carroll, Carter, Casey, Christian, Clark, Clay, Daviess, Edmonson, Elliott, Estill, Fayette, Fleming, Floyd, Franklin, Garrard, Grant, Grayson, Greenup, Hardin, Hart, Henry, Hickman, Hopkins, Jackson, Jefferson, Jessamine, Johnson, Kenton, Knott, Knox, Laurel, Lawrence, Leslie, Lincoln, Logan, Madison, Marion, Marshall, Martin, McCracken, Meade, Menifee, Montgomery, Morgan, Nelson, Ohio, Pendleton, Powell, Pulaski, Rowan, Russell, Shelby, Simpson, Spencer, Taylor, Warren, Washington, Whitley and Wolfe (Total counties with outbreak-associated cases: 76).
Similar to hepatitis A outbreaks in other states, the primary risk factors have been illicit drug use and homelessness. A common source of infection has not been identified, and HAV transmission is believed to occur through person-to-person contact. Kentucky is experiencing a 70% hospitalization rate and one death as a result of the hepatitis A outbreak. It is important to note that the individual who died had other health issues that contributed to their death.
Several food service workers across the state have also been infected, potentially exposing co-workers and patrons of their grocery and restaurant establishments, though the CDC considers the risk to patrons to be extremely low. No outbreak cases have been linked to exposure to a food service establishment to date.
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What You Should Know About Hepatitis A
- CDC notes that HAV infection rates in the United States have declined by 95% since the hepatitis A vaccine became available in 1995.
- The most recent national data indicated that in 2014 1,239 cases were reported from all 50 states to the CDC.
- Historically, Kentucky averages about 20 cases of hepatitis A per year.
What is hepatitis?
"Hepatitis" means inflammation of the liver. The liver is a vital organ that processes nutrients, filters the blood and fights infections. When the liver is inflamed or damaged, its function can be affected. Hepatitis is most often caused by a virus. In the United States, the most common types of viral hepatitis are Hepatitis A, Hepatitis B and Hepatitis C. Heavy alcohol use, toxins, some medications and certain medical conditions can also cause hepatitis.
What is Hepatitis A?
Hepatitis A is a highly contagious liver infection caused by the Hepatitis A virus. It can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months.
How Common is Hepatitis A?
Hepatitis A still occurs in the United States, although not as frequently as it once did. Over the last several decades, there has been more than 90% decrease in Hepatitis A cases. New cases are now estimated to be around 3,000 each year. Many experts believe this decline is a result of the vaccination of children and people at higher risk. Many of the new cases, however are from American travelers who got infected while traveling to parts of the world where Hepatitis A is common.
How is Hepatitis A Spread?
Hepatitis A is usually spread when a person ingests fecal matter - even in microscopic amounts - from contact with objects, food or drinks contaminated by feces or stool from an infected person. Hepatitis A can be spread when:
- An infected person does not wash his/her hands properly after going to the bathroom and then touches objects or food.
- A caregiver does not properly wash his or her hands after changing diapers or cleaning up the stool of an infected person.
- Someone engages in sexual activities with an infected person.
Hepatitis A also can be spread through contaminated food or water. Contamination of food can happen at any point: growing, harvesting, processing, handling and even after cooking. This most often occurs in countries where Hepatitis A is common.
Who is at risk for Hepatitis A?
Although anyone can get Hepatitis A, some people are at greater risk, such as those who:
- Travel to or live in countries where Hepatitis A is common
- Have sexual contact with someone who has Hepatitis A
- Are men who have sexual encounters with other men
- Use recreational drugs, whether injected or not
- Have clotting-factor disorders, such as hemophilia
- Are household members or caregivers of a person infected with Hepatitis A
What are the symptoms of Hepatitis A?
Not everyone has symptoms. If symptoms develop, they usually appear 2 to 6 weeks after infection and can include:
- Loss of Appetite
- Abdominal pain
- Dark urine
- Grey-colored stools
- Joint pain
Symptoms are more likely to occur in adults than in children. They usually last less than 2 months, although some people can be ill for as long as 6 months.
How is Hepatitis A diagnosed and treated?
A doctor can determine if a person has Hepatitis A by discussing his or her symptoms and taking a blood sample. To treat Hepatitis A, doctors usually recommend rest, adequate nutrition, fluids and medical monitoring. Some people will need to be hospitalized. It can take a few months before people begin to feel better.
How serious is Hepatitis A?
Most people who get Hepatitis A feel sick for several months, but usually recover completely and do not have lasting liver damage. Sometimes Hepatitis A can cause liver failure and death, although this is rare and occurs more commonly in people older than 50 and people with other liver diseases.
Can Hepatitis A be prevented?
Yes. The best way to prevent Hepatitis A is by getting vaccinated. Experts recommend the vaccine for all children, and people with certain risk factors and medical conditions. The vaccine is also recommended for travelers to certain international countries, even if travel occurs for short times or on closed resorts. The Hepatitis A vaccine is safe and effective and given as 2 shots, 6 months apart. Both shots are needed for long-term protection. You can get vaccinated at your doctor's office as well as travel clinics and other locations (like the Oldham County Health Department!). Lower cost vaccination may be available at certain pharmacies and your local health department.
Who should get vaccinated against Hepatitis A?
Vaccination is recommended for certain groups, including:
- All children at age 1 year
- Travelers to countries where Hepatitis A is common
- Family and caregivers of adoptees from countries where Hepatitis A is common
- Men who have sexual encounters with other men
- Users of recreational drugs, whether injected or not
- People with chronic or long-term liver disease, including Hepatitis B or Hepatitis C
- People with clotting-factor disorders