The Hep A Outbreak: Should I Be Concerned?

A recent rise in reported cases of Hepatitis A may be due, in part, to a good thing. More people are aware of the health concern – and they are getting tested.

The number of reported Hep A cases in 2019 has already surpassed those in 2018, according to the Florida Department of Health. Recently, the Florida Surgeon General declared a Public Health Emergency in response to the state’s increase in Hepatitis A cases, which is part of a national outbreak. Researchers and doctors haven’t yet pinpointed a specific cause, such as a public water or food sanitation problem.

News of a viral outbreak can be frightening and confusing. But there are actions you and your family can take to help avoid catching or spreading this infectious disease.

How serious is Hepatitis A?

The Hep A virus causes a disease of the liver.

Symptoms can include:

• fever
• fatigue
• loss of appetite
• nausea/vomiting
• diarrhea
• abdominal pain
• dark urine
• clay-colored stools
• joint pain
• yellowing of the skin and eyes (jaundice)

Older children and adults typically experience these symptoms. However, young children may have the infection but not the symptoms. Symptoms can start two to seven weeks after exposure to the virus. They usually last for less than two months, although some people can experience Hep A symptoms for up to six months.

Most people recover from the disease without chronic liver damage. Death from Hep A is rare, but has occurred.

How does Hepatitis A spread?

According to the Centers for Disease Control and Prevention (CDC), most cases of Hep A are contracted through water or food contaminated with fecal matter from an infected individual.

“People with Hep A are disproportionally homeless,” said Dr. Eugene Schiff, a hepatologist with the University of Miami Health System who specializes in liver diseases.

This may be because homeless populations often have limited access to clean water, sanitary food, and the means to maintain personal hygiene. Also, the disease tends to spread among those living and working in areas with poor sanitation. Intravenous drug users and those in close contact with an infected person are also at risk.

How can you protect yourself and loved ones from Hep A infection?

According to the Advisory Committee on Immunization Practices, anyone with a higher risk for coming in contact with this virus should get the Hepatitis A vaccine. This includes people in direct contact with someone who has Hep A, men who have sexual contact with men, travelers to countries where hepatitis A is common and those in close contact with visitors from those areas, drug users, people with blood clotting disorders, and those who work closely with nonhuman primates.

Dr. Schiff, who once served as an epidemic intelligence service officer for the CDC, is insisting on a wide-reaching approach to prevent the spread of this virus. “Everyone in the state of Florida should be vaccinated. That sounds dramatic, but it isn’t. I’m talking about doing something constructive to make a real difference. Rather than trying to figure out why this increase in cases or increase in awareness is happening in Florida and other parts of the country, let’s just vaccinate everyone to reduce the prevalence.”

The CDC recommends that all children receive the Hep A vaccine, beginning at age 1. “This is the age when children are more likely to respond to the vaccine (even if the mother already had the infection),” Dr. Schiff says. “Many don’t have their children vaccinated out of fear. But those fears are unfounded. It’s a shame. There’s no possible risk of getting hurt by the Hepatitis A vaccine. It’s safe and very effective. After you’re vaccinated, within two weeks, you’ll develop a protective antibody.”

Where is the vaccine available?

If your physician’s office doesn’t carry the vaccine, contact the Florida Department of Health to learn where it’s available.

“We should take the bull by the horns and have everyone vaccinated,” Dr. Schiff says. “If many people get vaccinated, in time, the number of Hep A cases will go down and will eventually be lower than historical norms. We don’t want to go back to the norm. We don’t want this to continue to be an issue in Florida and throughout the U.S. Our focus needs to be on vaccinating everyone to get this under control.”

Dana Kantrowitz is a contributing writer for UMiami Health News.

Tags: Dr. Eugene R. Schiff, hepatitis a, public health, Vaccines