By Robert Niezgoda, MPH
Since June of 2018, a total of 1,531 cases of Hepatitis A have been confirmed in Ohio with additional cases continuing to be reported in areas of the state.
Montgomery and Butler counties, in the Southwest part of the state, have reported more than 450 of the total number of reported cases. Other counties such as Franklin and Hamilton have reported over 100 cases each since the beginning of the outbreak.
These reported number of cases are significantly higher than the average number of reported cases of Hepatitis A in Ohio. On averages, 45 cases of Hepatitis A are reported annually in the state. In contrast, almost 50 cases have been reported during the last week alone.
Hepatitis A is a viral infection transmitted from person-to-person through the fecal-oral route. This occurs as viral particles in feces from the infected person are ingested through contact with contaminated objects or through the ingestion of contaminated food or water.
Signs and symptoms of Hepatitis A infection include: fever, fatigue, loss of appetite, nausea, vomiting, diarrhea, dark urine, abdominal pain, clay-colored bowel movements, joint pain, and jaundice. Infections in children younger than 6 years of age are asymptomatic in 70% of cases while most older children and adults have symptoms. 1
The average incubation period of Hepatitis A virus is 28 days with a range of 15 to 50 days.
According to the Centers for Disease Control, the clinical case definition for acute viral hepatitis is defined as “discrete onset of symptoms consistent with hepatitis (e.g., nausea, anorexia, fever, malaise, or abdominal pain) AND either jaundice or elevated serum aminotransferase levels.” The CDC indicates that Hepatitis A diagnosis must be confirmed by a positive serologic test for immunoglobulin M (IgM) antibody to hepatitis A virus, or the case must meet the clinical case definition and occur in a person who has an epidemiologic link with a person who has laboratory-confirmed hepatitis A. 2
Local health departments have implemented prevention measures including vaccination of those at risk and implementing vaccination clinics at homeless shelters, rehabilitation facilities, and correctional facilities. High-risk categories are defined as those who use illegal drugs; those who have been incarcerated recently; travelers to countries where hepatitis A is common; those who have been homeless recently; and men who have sex with men. Vaccination is also being provide to caregivers of those who are at risk.
The state department of health and local health departments have also been providing education to the public and encouraging good hygiene, such as hand-washing and not working in food service if ill.
While the outbreak is continuing, there are areas of the state where the number of cases being reported is decreasing.
- Centers for Disease Control and Prevention, Hepatitis A Questions and Answers for Health Professionals. https://www.cdc.gov/hepatitis/hav/havfaq.htm#general. Viewed on 1.29.19.
- Centers for Disease Control and Prevention, Case Definition of Hepatitis A. 2012. https://wwwn.cdc.gov/nndss/conditions/hepatitis-a-acute/case-definition/2012/ Viewed on 1.29.19.