Pestilence: Hepatitis A Outbreak Across The U.S.

Hepatitis A Outbreaks Flare Up Across U.S.

By 

Arian Campo-Flores and 

Betsy McKay

Hepatitis A outbreaks are erupting across the U.S., reversing a long-term decline in cases of the viral liver disease and prompting state health departments to mount aggressive vaccination campaigns.

Since outbreaks of the virus began in 2016, 30 states have reported cases totaling more than 26,000, including 268 deaths.

Most cases of hepatitis A in past years were caused by tainted food. The virus is transmitted when a person ingests food or water contaminated with the feces of someone who is infected.

Contagion

But now, outbreaks are larger and driven in part by the opioid epidemic that has swept the country in the past few decades, public-health officials say. Cases also are occurring among users of other drugs, including those who share contaminated needles, people who are homeless, and men who have sex with men.

“What we’re seeing today is really unusual,” said Neil Gupta, an expert in viral hepatitis at the Centers for Disease Control and Prevention. “The general public tends to think about hepatitis A as transmitted by restaurants. That’s not what is going on right now.”

Contagion

The disease usually can be treated with rest and fluids, but many patients require hospitalization, and in some cases it can be fatal.

A CDC committee first recommended preventing hepatitis A through immunization in 1996, focusing on high-risk groups, and counseled routine vaccination of children nationwide starting in 2006. The number of cases declined steadily in the 2000s, and large sustained outbreaks in which the virus is spread from person to person became rare.

The opioid crisis contributed to a reversal. Large numbers of hepatitis A cases are concentrated in states hard hit by the drug scourge, including Ohio, Tennessee and West Virginia, according to CDC data.

In Florida, state Surgeon General Scott Rivkees declared a public-health emergency in August in response to a hepatitis A outbreak that is now among the largest in the U.S. The state has had more than 3,000 cases since 2018 and 40 deaths, he told a legislative committee last month. Many are concentrated in a populous and heavily trafficked stretch of the state between Tampa Bay and Daytona Beach.

In Pasco County, which has the highest number of cases in Florida so far this year, the local office of the state health department has been trying to reach target populations by visiting homeless camps and areas with high volumes of fire-rescue and law-enforcement calls. In neighboring Pinellas County, the department deploys teams of health workers carting coolers of vaccines to places such as bus terminals and low-cost motels.