In an update on the hepatitis A outbreaks of four midwestern states battling the viral disease, we look at the numbers in West Virginia, Kentucky, Indiana and Michigan.

West Virginia

Hepatitis A is manifested here as icterus, or jaundice of the conjunctivae and facial skin/CDC
Hepatitis A is manifested here as icterus, or jaundice of the conjunctivae and facial skin/CDC

Since March 2018, the West Virginia Bureau for Public Health has reported an increase in the number of confirmed cases of acute hepatitis A virus.

As of Aug. 3, health officials have reported 791 outbreak cases. While cases have been reported in two dozen counties, the bulk of the cases are reported in two counties–Kanawha (416) and Cabell (167).

Six out of 10 people required hospitalization and two deaths were reported.

This increase in cases has primarily been among injection and non-injection drug users, homeless or mobile individuals, and those who have been recently incarcerated. Viral sequencing has linked cases from Kentucky and California.

Kentucky

Since August 1, 2017 through July 24, 2018, Kentucky health officials have  identified 1,221 cases of acute hepatitis A, a liver disease caused by hepatitis A virus. An increase in cases since Aug. 1, 2017, primarily among the homeless and drug users, prompted declaration of a statewide outbreak in Nov. 2017.

687 people required hospitalization and eight deaths were recorded.

Viral sequencing has linked several outbreak-associated cases in Kentucky with outbreaks in California and Utah.

Indiana

Hepatitis A Vaccine Image/National Institute of Diabetes and Digestive and Kidney Diseases
Hepatitis A Vaccine
Image/National Institute of Diabetes and Digestive and Kidney Diseases

Since November 2017, the Indiana State Department of Health (ISDH) has been investigating an outbreak of acute hepatitis A virus (HAV).  Through Aug. 3, 334 outbreak cases have been reported with 45 percent requiring hospitalization and one death.

Most of the cases have been reported in the southern counties of the state.

Cases have been infected with HAV strains genetically linked to outbreaks across the United States. Indiana has an average of 20 cases of hepatitis A per 12 month period.

Michigan

Public health officials and the Michigan Department of Health and Human Services (MDHHS) are continuing to see an elevated number of hepatitis A cases in the state.

As of August 1, 2018, 869 cases were reported with 80 percent of patients requiring hospitalization. 27 deaths have been reported.

Macomb County, Detroit, Wayne and Oakland counties have reported the most cases.

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