The City of Cincinnati, OH health officials are reporting an increase in hepatitis A cases in 2018. From 2015 through 2017 there were 0 confirmed or probable cases of hepatitis A among city residents. To date, in 2018, there have been 5 confirmed cases, with 6 additional potential cases.

Image/Robert Herriman
Image/Robert Herriman

The groups most frequently affected in these recent outbreaks have been: individuals experiencing homelessness; individuals who use street drugs, whether injected or not; men who have sex with men; individuals who have been incarcerated; and individuals who have had contact with known cases.

“We are currently working on vaccinating our at-risk populations, increasing awareness and education on prevention, and increasing access to hand washing and other hygiene resources,” said Sharon Hutchins, Ph.D., MPH, Supervising Epidemiologist of the Communicable Disease Unit.

Research and recent experience with hepatitis A outbreaks have shown that vaccination is the single most effective way to halt the spread of hepatitis A. Hepatitis A is primarily spread when a person ingests fecal matter from contact with objects, food, or drinks contaminated by the stool of an infected person. Hepatitis A also can spread from close personal contact with an infected person.

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“People infected with the hepatitis A virus are most infectious the first and second week prior to symptom onset and infectiousness can continue for a few weeks to months,” explained Dr. Hutchins. “Those infected or possibly exposed are urged to be particularly thorough in hand washing after toileting and prior to food preparation to avoid any potential further spread of disease,” Dr. Hutchins continued.

On June 22, 2018, the Ohio Department of Health (ODH) declared that Ohio had a hepatitis A outbreak occurring primarily among the communities mentioned above. As of July 16, 2018, the state of Ohio had 137 reported cases connected to this outbreak. This outbreak is being caused by a single type of hepatitis A.