Thirty one cases have been reported in Ohio.

As nearby states battle hepatitis A outbreaks, is Ohio next?

The number of hepatitis A cases in Ohio and neighboring states has spiked since January, the Ohio Department of Health reported, concerning some local public health officials.

There have been 47 cases across the state, the highest since 2015, according to the state. In comparison, there were five cases during the same period in 2017, two in 2016 and five in 2015. Hepatitis A is a vaccine-preventable, communicable disease of the liver caused by the hepatitis A virus. It is usually transmitted by person-to-person through contact with an infected person’s stool, or consumption of contaminated food or water, the release said.

“One thing you want to do is make sure your food is thoroughly cooked,” said Dan Suffoletto, public information supervisor at Public Health–Dayton & Montgomery County.

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In 2017, there was one case of hepatitis A in Montgomery County, and two cases in 2018 so far. The cases have not specifically been linked to other state outbreaks, Suffoletto said. He said there is a vaccine available for people who are at risk for contracting hepatitis A.

“You can even get it here at public health,” he said.

Ohio is the latest state to be affected by the Hepatitis A outbreak. Neighboring states such as Indiana, Kentucky and Michigan have all been affected. California and Utah are also experiencing outbreaks. The cases have primarily occurred in people who are homeless, using injecting and non-injection drugs, and their close direct contacts, according to the Centers for Disease Control.

Hepatitis A is an infection of the liver caused by a virus, the hepatitis A virus. Approximately one-third of United States citizens have evidence of prior hepatitis A infection, and 100 deaths are attributed to hepatitis A every year, according to the Ohio Department of Health.

Dr. Jonathan Pope, an infectious diseases specialist for Premier Physicians Network, said since the early 2000s, all children are vaccinated for hepatitis A and adults at risk should also get vaccinated. People who have been exposed or who have hepatitis B or C should also be vaccinated.

“It’s important to know that if you get it, most likely you’ll recover,” he said.

Symptoms include fatigue, nausea, abdominal pain, loss of appetite, low-grade fever and yellowing skin. A blood test can confirm a diagnosis.

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While some cases in Ohio have been linked to other state outbreaks, Ohio is not having an outbreak. In neighboring Kentucky, approximately 311 cases have been reported since August 2017 — with the outbreak centered in Jefferson County. In Indiana, about 40 cases have been reported, according to the State Department of Health.

A confirmed case of hepatitis A includes both a positive laboratory test and symptom onset, with either jaundice or elevated liver function tests. Outbreaks have been linked to contact with known hepatitis A case; homelessness; IV drug use; and men who have sex with men, according to the CDC.

The rate of hepatitis A has dramatically decreased in Ohio and nationwide in the past 15 years. One major outbreak of hepatitis A in Ohio occurred in 1998, when three outbreaks were reported — involving 210 people. Then due to a multi-state outbreak of hepatitis A in 2003, 34 percent of Ohio cases with symptom onset in that year were suspected to be involved in an outbreak.

“The best way to prevent hepatitis A among high-risk individuals is to get vaccinated,” said ODH Medical Director Dr. Clint Koenig. “The Centers for Disease Control and Prevention recommends the hepatitis A vaccine for all children at age 1 and for at-risk individuals.” 

Historically, widespread epidemics of acute hepatitis A have occurred in the United States approximately every 10 years. The last epidemic occurred in 1989. Since 1995, the incidence of hepatitis A has been declining and has been at an all-time low since 1998, most likely due to the increased utilization of the hepatitis A vaccine, according to the Ohio Department of Health.

How does hepatitis A occur?

• Eating food made by an infected person who did not wash his or her hands after using the bathroom

• Drinking untreated water or eating food washed in untreated water

• Placing a finger or an object in your mouth that came into contact with an infected person’s stool

• Having close personal contact with an infected person, such as through sex or caring for someone who is ill

Source: Green County Health Department

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