Kentucky’s Hepatitis A Outbreak Claims First Casualty

In Kentucky, the ongoing Hepatitis A virus outbreak may now include the death of a Louisville resident, according to health officials.

This is the first known death from acute hepatitis A in Kentucky since the hepatitis A outbreak began in 2017.

The multi-county outbreak of Hepatitis A remains ongoing with the Kentucky Department for Public Health (DPH) now reporting 150 cases.

Most of these Hepatitis A cases have been reported from the Louisville Metro area, according to DPH, 124 of the cases were reported in Jefferson County.

An employee who worked at two Waffle House restaurants in Boyd County was diagnosed with Hepatitis A, according to the Ashland-Boyd County Health Department.

The window of possible exposure for the worker was February 12 to 28, the health department said.

Kentucky’s 10-year average number of acute hepatitis A cases has been approximately 20 cases per year.

Similar to hepatitis A outbreaks in other states, the primary risk factors for Kentucky cases have been illicit drug use and homelessness.

Laboratory specimens for some cases have been sent for specialized genetic testing at the Centers for Disease Control and Prevention (CDC) in Atlanta to determine if Kentucky’s cases are associated with outbreaks in other states.

To date, 38 cases from 45 specimens submitted to CDC had hepatitis A virus that genetically matched outbreaks in California and Utah.  

No single source of infection has been identified and virus transmission is believed to be occurring through person-to-person contact.

The Louisville Metro Department of Public Health and Wellness has given more than 4,700 immunizations against hepatitis A at homeless shelters, homeless camps and at agencies, such as the Phoenix Health Center.

Additionally, it has also been providing immunizations at its syringe exchange sites and in the Louisville Metro corrections facility to target drug users and prevent the spread of hepatitis A in the prison system.

Hepatitis A is a vaccine-preventable, communicable disease of the liver caused by the hepatitis A virus.

The hepatitis A vaccine has been routinely recommended for children in Kentucky aged 12 to 23 months since 2006, reports the DPH.

State officials also recommend catch-up immunizations to prevent hepatitis A for children aged 2 through 18 years.

Children in all public and private schools in Kentucky will need to be immunized with hepatitis A vaccine before starting school on or after July 1, 2018, unless their parents or legal guardians assert an exemption based upon religious beliefs.

Hepatitis A vaccines are more than 90 percent effective in protecting someone who may be exposed to the disease.

Other than age-appropriate vaccinations, the best way to keep from getting hepatitis A is to wash your hands using warm water and soap, to handle uncooked food appropriately, and to fully cook food.

Hepatitis A is a self-limited disease that does not result in chronic infection. Most adults with hepatitis A have symptoms, including fatigue, low appetite, stomach pain, nausea, and jaundice, that usually resolve within 2 months of infection, says the CDC.

For people who do have contact with a person with Hepatitis A virus, Post Exposure Prophylaxis (PEP) is recommended by the CDC for unvaccinated people who have been exposed to hepatitis A virus in the previous 2 weeks.

In the USA, there are three FDA approved hepatitis A vaccines:

• Vaqta and Havrix are approved for people ≥12 months of age in a 2-dose series
• A combined hepatitis A and hepatitis B Twinrix vaccine is approved for people ≥18 years of age in the United States.

The CDC Vaccine Price List provides current HAV vaccine contract prices and general information. Hep A vaccine discounts can be found here.

Vaccines, like any medicine, can have side effects, says the CDC. You are encouraged to report negative side effects of vaccines to the FDA or CDC.