Hepatitis A Outbreak in Kentucky is Not Over Yet

A hepatitis A outbreak in Kentucky is now the largest outbreak in US and Kentucky history. A total of 1170 cases of acute hepatitis A have been reported in the state since August of 2017.

Hepatitis A outbreaks have sprung up in 10 states this year. Ohio is the latest to declare an outbreak, with 156 cases across 31 counties.

Health officials have determined that the hepatitis A outbreak in Kentucky is linked with the strain of the virus that has spurred outbreaks in both San Diego, California and Salt Lake City, Utah.

In addition to surveillance of individuals infected with the virus, health care providers across Kentucky are working alongside health officials to protect individuals from being infected, especially young children. According to the US Centers for Disease Control and Prevention, less than 10% of children under 6 years of age will shows signs of infection. As such, state officials have amended the Kentucky state immunization regulation to state that all children between the ages of 1 and 18 must receive the 2-dose series of the hepatitis A immunization in order to attend a licensed day care or public or private school in the state of Kentucky. The regulation went into effect on July 1 and must be met prior to the start of the 2018-2019 school year.

Vaccination campaigns for adults were initiated as well and as of July 19, the Louisville Department of Public Health and Wellness reported that more than 78,000 hepatitis A immunizations have been administered.

Health officials are also deploying outreach efforts to target high-risk individuals such as homeless individuals and people who inject drugs. These individuals make up the majority of the population infected with hepatitis A. Efforts include setting up vaccination clinics at shelters, camps, and facilities.

“I can’t overemphasize the importance of protecting yourself and others from hepatitis A by getting vaccinated,” Sarah Moyer, MD, director, Department of Public Health and Wellness, Louisville Metro, shared in a statement. “This vaccine is very well-tolerated. Most insurance plans cover the cost and there are ways those who are uninsured can get immunized for little to no cost. The outbreak will stop when most people living in Louisville [Kentucky] are protected through vaccination.”

So far, there is no evidence to suggest that the virus is being spread through food as was the case during the 1988 outbreak of hepatitis A in Jefferson County that was linked with a common source of fresh produce; however, approximately 6200 food service workers across the Kentucky have been vaccinated.

Despite the startling number of Kentucky citizens that have been infected, health officials are reporting a decrease in the number of new cases per day in Louisville, down from an average of 4.1 cases per day in April, to an average of 1.67 new cases per day in July.

Furthermore, health officials report that only 8 deaths have occurred. They attribute the low mortality rate to increased surveillance and prompt treatment of those affected. About 60% of those infected with hepatitis A (658 individuals) have been hospitalized.

Although the number of cases is declining, Louisville health officials are warning that the outbreak is still not over, and the threat of infection is still possible.

“While there is evidence that new cases may be trending downward in Louisville,” said Dr. Moyer in the statement, “this no time to get complacent. Anyone can get hepatitis A during this outbreak. It is being spread through person-to-person contact. The best ways to protect yourself and others are to get vaccinated and wash your hands often with soap and warm water.”

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.