Employees at two local Louisville, Kentucky businesses have been diagnosed with Hepatitis A.

That has been a similar and common headline in newspapers across the country over the last several months.

One worker at Sarino (1030 Goss Avenue) was diagnosed. Customers who dined at the establishment from February 24 through March 15 may have been exposed to the virus. One worker from Kroger (520 N 35th Street) was diagnosed. Customers who shopped at the store from March 2 through March 19 may have been exposed to the virus.

Kentucky

Since Jan. 1, 2017, the Kentucky Department for Public Health (KDPH) has identified 198 confirmed cases of acute hepatitis A, a liver disease caused by hepatitis A virus. An increase in cases since Aug. 1, 2017, primarily among the homeless and drug users, prompted declaration of a statewide outbreak in Nov. 2017. Viral sequencing has linked several outbreak-associated cases in Kentucky with outbreaks in California and Utah.

KDPH is working closely with the Centers for Disease Control and Prevention and local health departments to provide guidance and education to health professionals and at-risk populations. Treatment for acute hepatitis A generally involves supportive care, with specific complications treated as appropriate. Hepatitis A is a vaccine-preventable disease.

Counts as of Mar. 17, 2018

  • Total Outbreak: 198
  • Hospitalizations: 142
  • Deaths: 1

Utah

Since January 1, 2017, Utah public health has identified 226 confirmed cases of hepatitis A virus (HAV) infection; many among persons who are homeless and/or using illicit drugs. Several cases have been linked by investigation and/or viral sequencing to a national outbreak of hepatitis A involving cases in California and Arizona. Hospitalization rates of less than 40% have been described in previous hepatitis A outbreaks; however, other jurisdictions associated with this outbreak are reporting case hospitalization rates approaching 70%.

California

On Jan. 23, 2018, the San Diego County ended the local health emergency, declared on September 1, 2017, in response to the local hepatitis A outbreak. The action does not mean the outbreak is over, and the County will continue efforts it has taken to control the spread of the disease.  There has been a total of 586 illnesses, 401 hospitalizations and 20 deaths.

Arizona

Arizona officials believe the local outbreak was mainly confined to homeless people in Maricopa County. The county recorded only 15 known cases and no deaths, and officials have detected no new Arizona cases since the end of May 2017.  The illnesses in Arizona were linked to a person who traveled from San Diego.

Michigan

Since the beginning of the outbreak in August 2016, the Michigan public health response has included increased healthcare awareness efforts, public notification and education, and outreach with vaccination clinics for high-risk populations. No common sources of food, beverages, or drugs have been identified as a potential source of infection. Transmission appears to be through direct person-to-person spread and illicit drug use. Those with history of injection and non-injection drug use, homelessness or transient housing, and incarceration are thought to be at greater risk in this outbreak setting. Notably, this outbreak has had a high hospitalization rate.  There has been a total of 789 illnesses, 635 hospitalizations and 25 deaths.

What about all the rest of the states?  What is the cause?  What is the source?  What can we do – in addition to vaccinations – to stop this?