Indiana health officials, state and local, are responding to an increase in hepatitis A cases in southern counties, many of which are tied to a large outbreak in Kentucky.

Indiana county map/ISDH
Indiana county map/ISDH

In the last month, 17 cases of hepatitis A have been confirmed statewide, including 11 in Clark and Floyd counties. The Indiana State Department of Health (ISDH) reports since Jan. 1, they have confirmed 40 cases of hepatitis A statewide. Typically, fewer than 20 cases are confirmed each year in Indiana.

Many of the southern Indiana cases have involved inmates in the Clark County Jail. However, an elementary school in Clark County and a Bob Evans restaurant on State Street in New Albany also have been impacted.

“Hepatitis A is a highly contagious virus, and seeing this many cases in such a short timeframe is concerning,” said State Health Commissioner Kris Box, MD, FACOG. “We are working closely with our local partners to identify individuals who may have been exposed and to halt the transmission of disease.”

Kentucky has been responding to a hepatitis A outbreak since the beginning of last year. Since Jan. 1, 2017, the Kentucky Department for Public Health (KDPH) has identified 198 confirmed cases of acute hepatitis A, including one death.

An increase in cases since Aug. 1, 2017, primarily among the homeless and drug users, prompted declaration of a statewide outbreak in Nov. 2017. Viral sequencing has linked several outbreak-associated cases in Kentucky with outbreaks in California and Utah.

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Hepatitis A is a viral infection of the liver. It is generally transmitted via fecal-oral routes or through consumption of contaminated food or water. Individuals can contract the virus through contact with:

  • Foods prepared or served by an infected person(s)
  • Stool or blood of an infected person(s)
  • Inanimate objects that may have trace amounts of fecal material from hand contact
  • Shared syringes or “works” used to inject drugs

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Symptoms vary greatly, from severe to none at all, and may include loss of appetite, nausea, fatigue, fever, stomach ache, dark (cola) colored urine and light colored stools. Jaundice (yellowing of the eyes or skin) may appear a few days after the onset of these symptoms. Individuals can become ill 15 to 50 days after being exposed to the virus. Most people who get hepatitis A feel sick for several weeks, but they usually recover completely and do not have lasting liver damage. However, hospitalization and, in rare cases, death can occur.