Hepatitis A outbreak continues to grow in Ohio

Montgomery and Butler counties have the highest number of cases in the state.

Ohio has topped more than 1,500 cases of hepatitis A since June, and the outbreak is still growing in parts of the state.

New cases of the illness appear across Ohio daily. Montgomery and Butler counties tally some of the highest counts, with a combined more than 450 cases. Franklin and Hamilton counties also reported more than 100 cases each.

The epidemic is slowing in those areas hit first and hardest, including in both Montgomery and Butler counties, but it doesn’t mean the outbreak is nearing an end.

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Across the state, a normal year would have roughly 45 occurrences. There have been nearly 50 in the last week alone and 1,531 in the past eight months, said the state’s epidemiologist Sietske de Fijter.

In other parts of Ohio that weren’t hit as hard initially and didn’t start prevention efforts as early, the rate of new cases is still on the rise and haven’t peaked yet, de Fijter said.

Local health departments are making major pushes to vaccinate at-risk individuals and those who work closely with them, including on-site clinics at homeless shelters, rehabilitation facilities and prisons. Those in the high-risk category include street drug users; those who are or have recently been incarcerated; those who have traveled to countries where hepatitis A is common; the homeless or who recently were homeless; and men who have sex with men.

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But anyone could get hepatitis A if they touch their mouth or eat food after coming in contact with fecal matter from an infected individual. It can also be spread through close physical contact, such as through sex. Anyone can be vaccinated, and it’s covered by most insurance providers, de Fijter said.

The vaccination is typically given to children after they turn one year old. But that vaccine didn’t become available until 1996, so many adults have not received it, adding to the high count, she said. Children also may not have received it as it is recommended, but not required.

The two-dose vaccination lasts a lifetime, so anyone who has already received the series at some point is protected, said Montgomery County Public Health spokesman Dan Suffoletto.

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The state has provided more than 33,000 vaccinations at public health departments since the outbreak began in June. Those vaccinations are provided by the CDC for outbreak response.

Counties getting people vaccinated

In 2018, Montgomery County provided 3,108 hepatitis A vaccinations and did 100 outreach clinics to provide vaccinations for those at the most risk, Suffoletto said. Butler County has given more than 2,000 vaccinations to high-risk groups as well, according to the county’s health department website. Others have received vaccinations at clinics and their family doctors.

“We usually have between zero and one case of Hepatitis A per year. So even though we’re in the single digits per week, that’s not where we want to be,” said Jenny Bailer, health commissioner for Butler County.

How to avoid hepatitis A

Southern Ohio is especially impacted with higher numbers of illnesses because it is more heavily impacted by the opioid epidemic, de Fitjer said.

In addition to vaccines, the state department of health has been working with local health departments to provide education and work toward policy change like requiring vaccinations for food workers.

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Practicing good hygiene is also vital, especially after touching surfaces that others also frequently have contact with, such as telephones, computer keyboards and door handles, Suffoletto said.

“You want to make sure you’re washing your hands thoroughly and frequently, using soap and water, particularly when you’re eating or preparing food,” Suffoletto said.

While hepatitis A can cause liver failure and death, it is a rare occurrence that happens more commonly in people older than 50 years old and those with liver diseases. Five people have died in Ohio since the outbreak began and 957 required hospitalization.

Symptoms can include fever, feeling tired, a loss of appetite, joint pain, jaundice, dark urine, vomiting and nausea and grey stool, and can develop up to two to six weeks after the infection occurs.

“I’m positive, I’m an optimist,” de Fitjer said. “I’m hoping that all the work that we’re doing will slow things down and then hopefully we’ll come back to our natural state where we have about 40 to 45 cases per year.”

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