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How local health officials combated hepatitis A outbreak

Credit: DaytonDailyNews

Understanding Hepatitis A

Credit: DaytonDailyNews

Health officials say they have made significant progress in slowing the hepatitis A outbreak that left 16 Ohioans dead and 2,121 hospitalized since early 2018.

The outbreak isn’t over and there are still new Ohio cases being recorded, but the rate of new cases has sharply fallen in southwest Ohio, where the outbreak first began and where public health officials have been working the longest on combating the outbreak.

Hepatitis A spreads through ingesting microscopic pieces of fecal matter and there are typically about 40 cases a year across Ohio. from Jan. 5, 2018, to Jan. 6, 2020, there were 3,450 cases in Ohio, 2,121 hospitalizations and cases in 82 counties.

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Montgomery County was among Ohio counties hardest hit by the viral liver disease, with a peak 42 cases September 2018, but Public Health - Dayton & Montgomery County’s preliminary numbers show only one case each in November and December and no new cases in September and October.

Butler County was also hit hard, with 26 cases alone confirmed the week of Sept. 30, though cases started to fall after months of public health outreach. Jennifer Bailer, health commissioner for Butler County General Health District, confirmed they have not had a new report since August. She said the hard work of the health districts and departments paid off.

“The three local health districts/departments in Butler County worked together really well, and really hard to vaccinate high risk individuals and educate the public on risks,” Bailer said.

While anyone can get contract the virus, some of the most vulnerable patients are the homeless, those experiencing unstable housing, and people currently incarcerated or recently incarcerated.

Sietske de Fijter, state epidemiologist at Ohio Department of Health, said what made a big difference was the local health workers who brought vaccines out to meet people where they were at, so people in jail or in homeless shelters could have the opportunity to be vaccinated.

“That was a really important distinction and that really helped us in slowing down this outbreak and that’s what we heard from a lot of other states as well,” de Fijter said.

Before the cases started to rise in Ohio and the statewide outbreak declared in June 2018, the outbreak had already hit neighboring Kentucky. Cases first climbed in southwest Ohio, then more were seen in central Ohio and now there’s a concentration in northeast Ohio.

PREVIOUS COVERAGE: Butler, Montgomery counties lead the state in reports of hepatitis A cases

The CDC provided vaccines to the state and de Fijter said more than 70,000 doses of the vaccine were distributed through public health departments.

She said public health departments worked to fight the outbreak but also federally qualified health centers, behavioral health providers, jails and other groups helped with the efforts.

Dr. Mamle Anim, chief medical officer at Dayton-based Five Rivers Health Centers, said the federally-qualified health center focused on education and offering vaccinations, especially to those with chronic medical conditions who could be especially vulnerable.

She said they helped people understand how hepatitis A is spread, and that it is not blood borne but could be spread by food contaminated with the virus.

“We did patient education and also offered more vaccinations that we usually would,” Anim said.

Dan Suffoletto, spokesman for Public Health – Dayton & Montgomery County, said the county has “seen a dramatic decrease in the number of new cases.”

He said the department had activated an incident managed team to manage combating the outbreak, and at one point, they were holding off-site clinics to reach people such as at homeless shelters and the jail, but they have stopped as the cases of slowed.

Hepatitis A vaccines were recommended in the U.S. beginning in 1996. Suffoletto said if you are not sure if you have had the vaccine, it is safe to receive it again.

PREVIOUS COVERAGE: Hepatitis A and other diseases in Butler County rose sharply in 2018

Hepatitis A symptoms include fatigue, low appetite, stomach pain, nausea, light-colored stool and jaundice. Most of those affected feel sick for several months, recover and do not have lasting liver damage.

While it can cause liver failure and death, that is a rare occurrence that happens more commonly in people over 50 years old and those with liver diseases.

How to get a hepatitis A vaccine

You can get a vaccine through your provider, local pharmacies, retail clinics, or urgent care centers.

Public Health-Dayton & Montgomery County has hepatitis A vaccines at its downtown clinic in the Reibold Building, at 117 S. Main St. Services are by appointment. To schedule an appointment call 937-225-4550.

Butler County General Health District (513‐863‐1770), City of Hamilton Health Department (513‐785‐7080), or City of Middletown Health Department (513‐425‐1818) can help if you have no insurance or other barriers.