Five US States Have Been Hit by Serious Hepatitis A Outbreaks

Most health professionals know about the ongoing hepatitis A outbreak that is ravaging the state of California, but they may now know about the outbreaks that have also sprung up in Michigan, Colorado, Utah, and now, Kentucky.

Just last week, on November 21, 2017, the Kentucky Department for Public Health (DPH) declared an acute hepatitis A outbreak in the state of Kentucky that reportedly spans multiple counties including Shelby, Bullitt, Hardin, Henry, Anderson, Mason, Christian, Madison, Fayette, McCracken, Hopkins, Leslie, and Jefferson, which reported 19 out of the 31 confirmed cases.

The number of confirmed cases is a “50% increase above the average of 20 cases per year reported over the past 10 years,” according to a recent health alert.

The KDPH has teamed up with the Louisville Metro Department of Public Health and Wellness, and other health departments to cut back on the spread of the virus throughout the area. Twelve of the infected individuals from Jefferson County were cited as having risk factors that made them susceptible to the infection, such as homelessness and reported illicit drug use, much like the outbreak going on in San Diego. No associated deaths have been reported.

“Acute hepatitis A is a serious and potentially life-threatening infectious disease,” Johnathan Ballard, MD, state epidemiologist for KDPH, stressed in the press release. “We are working to identify anyone who has been exposed to cases associated with this outbreak and urging those experiencing symptoms of the illness to contact their health care provider for appropriate evaluation and medical treatment, if necessary.”

The outbreak in Kentucky may be the most recent, however, another hepatitis A outbreak has been ongoing on in the state of Utah since January 2017, with 87 outbreak-associated cases identified as of November 27, 2017. As with the outbreaks in California and Kentucky, many of the infected individuals are either homeless or illicit drug users. About 60% of those infected have required hospitalization, and the Utah Department of Health suggests that this high rate could be due to underlying illnesses (such as alcoholism) or a higher incidence of hepatitis B/C comorbidities. To address this outbreak, health officials have been channeling their efforts into promoting awareness and education on the virus, providing opportunities for vaccination, and identifying additional cases.

Meanwhile, Michigan is another state that has been heavily hit by the virus since August 2016. As of November 21, 2017, a total of 526 confirmed cases associated with the outbreak have been reported. Most of the cases are from Macomb County. According to the Michigan Department of Health & Human Services, Southeast Michigan continues to see a high number of cases. Although a common food, beverage, or drug source has yet to be identified by health officials, the main channel of transmission appears to be through direct person-to-person contact and, again, illicit drug use. Notably, this outbreak boasts a higher rate of hospitalization than the ongoing outbreak in Utah, with 436 (82%) of the 526 infected individuals requiring hospitalization. The death toll has reached 20.

Colorado is also suffering from an ongoing hepatitis outbreak that has affected a total of 62 individuals as of November 17, 2017. The virus has also claimed at least 1 life thus far. In fact, the Colorado Department of Public Health & Environment claims that the number of hepatitis A infections in the state is “more than double” that which the state typically sees on an annual basis. “Colorado’s hepatitis A outbreak mirrors similar outbreaks across the country,” state epidemiologist Rachel Herlihy, MD, MPH, expressed in a recent press release. “We’re seeing more cases among gay, bisexual, and other men who have sex with unvaccinated men. We want to get the word out: A safe and effective vaccine will protect you.”

Because of the increased demand for the hepatitis A vaccine, the Centers for Disease Control and Prevention (CDC) reportedly expressed that vaccine supplies are “constrained,” according to popular news outlet Food Safety News. “US-licensed manufacturers of adult hepatitis A vaccine are exploring options to decrease domestic supply and are working collaboratively with CDC to monitor and manage public and private vaccine orders to make the best use of supplies,” the CDC reportedly shared with the news outlet in a recent vaccine supply update. “Of note, the constraints described in this [note] do not apply to the pediatric hepatitis A vaccine supply in the United States.”

To stay up-to-date on the number of confirmed cases of hepatitis A in all outbreaks, be sure to follow the Contagion^® Outbreak Monitor.