The Kentucky Department for Public Health (DPH) has now reported 1,094 cases of hepatitis A in the current outbreak. Of this total, 57 percent, or 628 people required hospitalization and eight died.

Image/Robert Herriman
Image/Robert Herriman

The outbreak, declared last November, is easily the largest in the country and primarily affects the homeless and drug users.

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

In neighboring West Virginia, the case count continues to climb since March 2018. As of Friday, West Virginia health officials have reported 540 hepatitis A cases, including 351 hospitalizations (65%) and two deaths.

Health officials note that like Kentucky, the 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.


Hepatitis A is a vaccine-preventable liver disease that usually spreads when a person ingests fecal matter – even in microscopic amounts – from contact with objects, food or drinks contaminated by the stool of an infected person.  Hepatitis A can also be spread from close personal contact with an infected person, such as through sex.

People at increased risk for hepatitis A in this outbreak include: People with direct contact with individuals infected with the virus, men who have sex with men, people who use street drugs whether they are injected or not, people who are incarcerated, people experiencing homelessness and people who have traveled to other areas of the U.S. currently experiencing outbreaks.

Symptoms of hepatitis A include fatigue, low appetite, stomach pain, nausea, clay-colored stools and jaundice.  People with hepatitis A can experience mild illness lasting a few weeks to severe illness lasting several months.

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People who believe that they are at high risk for hepatitis A infection should contact their healthcare provider or local health department for information about vaccination.  People who know that they have been exposed to someone with hepatitis A should contact their healthcare provider or local health department to discuss post-exposure vaccination options.  Individuals who experience symptoms of hepatitis A should contact their healthcare provider.