Hepatitis A Outbreak Kills 14 In SE Michigan

METRO DETROIT, MI — The outbreak of hepatitis A in southeastern Michigan is continuing to increase, according to the Michigan Department of Health and Human Services. From Aug. 1, 2016 to Sept. 15 of this year, there have been 319 cases of confirmed hepatitis A — including 14 deaths.

These cases are from the city of Detroit, and Macomb, Monroe, Oakland, Wayne, and St. Clair counties. The number of cases is a sixteen-fold increase.State and county health officials are working together to fight the spread of the disease, including increasing vaccination efforts.

“The Southeast Michigan hepatitis A outbreak remains a top priority for public health officials from both the investigation and prevention standpoints,” Dr. Eden Wells, chief medical executive for MDHHS, said in a statement. “Hepatitis A is a vaccine-preventable disease and in addition to our investigation of current and new cases, our focus is strongly aimed at increasing vaccination in adults, where hepatitis A vaccination is commonly low.”

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Ages of the cases range from 20 to 87 years, with a median age of 42.5 years, and two-thirds of the cases (64 percent) are men. While no common source of the outbreak such as contaminated food or water has been identified, transmission does appear to be person-to-person through illicit drug use, sexual activity, and close contact among household members.

Over half of the cases (51 percent) have a history of substance abuse, 28 percent are co-infected with hepatitis C, 15 percent are homeless/in transient housing situations, and nineteen cases (6.4 percent) have a history of recent incarceration, state health officials said.

Health officials have been working to increase vaccination in at-risk populations. These activities include:

• There are ongoing vaccination campaigns in Macomb, Oakland, St. Clair, and Wayne jails, substance use treatment centers, and homeless centers, as well as discussion with the Michigan Department of Corrections about implementing a vaccination campaign in the Detroit Receiving Center and Detroit Detention Center.
• MDHHS is working with Detroit Health Department and regional Emergency Departments to implement a vaccination campaign targeting at-risk patients.
• Oakland County has dedicated resources to offer vaccinations to all employees and ongoing outreach activities to at risk individuals.

People with hepatitis A are infectious for two weeks prior to symptom onset. Symptoms of hepatitis A include jaundice (yellowing of the skin), fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, and light-colored stools.

Symptoms usually appear over a number of days and last less than two months; however, some people can be ill for as long as six months. Hepatitis A can sometimes cause liver failure and death.

Risk factors for a hepatitis A infection include living with someone who has hepatitis A, having sexual contact with someone who has hepatitis A, or sharing injection or non-injection illegal drugs with someone who has hepatitis A. The virus can also be transmitted through contaminated food or water.

Health officials recommend vaccination for the at–risk individuals, including:

• Health care workers who have direct contact with patients
• People who use injection and non-injection illegal drugs
• People who participate in commercial exchange of sexual practices
• People who are homeless or in transient living situations
• People who are or have recently been incarcerated
• Close personal contacts (e.g., household, sexual) of hepatitis A patients
• Food handlers
• Men who have sex with men
• People with liver diseases, such as hepatitis B or hepatitis C. Persons with chronic liver disease have an elevated risk of death from liver failure.
• Any person who wishes to be immune to hepatitis A
• People who live, work, or recreate in SE Michigan and are concerned about getting hepatitis A

Contact your local health department about how to receive the hepatitis A vaccine:

• Detroit Health Department, 313-876-4000
• Macomb County Health Department, 586-469-5372
• Monroe County Health Department, 1-888-354-5500, Ext. 7800
• Oakland County Health Division, 1-800-848-5533 or email noc@oakgov.com
• Clair County Health Department, 810-987-5300
• Wayne County Communicable Disease Unit, 734-727-7078

Photo by Joe Raedle / Staff / Getty Images News / Getty Images