In North Carolina, health officials have reported an increase in hepatitis A cases in 2018–64 through October, compared to a 5-year average of 41. In addition, the state is in the middle of an ongoing outbreak that has sickened 37.

On Tuesday, state health officials reported the first hepatitis A death linked to this outbreak.

North Carolina map/ National Atlas of the United States
North Carolina map/ National Atlas of the United States

Of the total cases, 70 percent have required hospitalization for their illness and of the outbreak total, Mecklenburg County has accounted for more than half the cases (20).

Hepatitis A is a contagious and vaccine-preventable liver infection that can range from a mild illness lasting a few weeks to a severe illness lasting several months. It is usually transmitted through food or water that has been contaminated with small, undetectable amounts of feces from a contagious person.

“The best way to protect yourself against hepatitis A is through vaccination,” said Dr. Heidi Swygard, viral hepatitis medical director in DHHS’ Division of Public Health. “Good handwashing is also important, especially after using the bathroom, changing diapers and before preparing or eating food. Anyone who thinks they may have been infected or exposed should seek medical attention.”

Multiple states have reported large outbreaks of hepatitis A associated with person-to-person transmission. Cases have occurred primarily among three risk groups: (1) persons who use injection or non-injection drugs; (2) persons who are experiencing homelessness; and (3) men who have sex with men.

In fact, since 2017, the Centers for Disease Control and Prevention has received more than 7,000 reports of hepatitis A linked to a multi-state outbreak with higher than expected hospitalization and death rates. Because hepatitis A causes inflammation of the liver, anyone with underlying liver disease is at risk of more serious illness if infected.

Symptoms of hepatitis A include fever, fatigue, nausea, loss of appetite and stomach pain. Jaundice (yellowing of the skin and/or eyes), dark-colored urine and clay-colored bowel movements may also occur. These symptoms can appear within 15-50 days (average 28 days) following infection with the virus.

DHHS advises anyone with symptoms of hepatitis A to contact their health care provider, who can perform a blood test for the virus. Anyone exhibiting these symptoms should refrain from preparing food for others. Patients can transmit the virus to others in the two weeks before and one week after jaundice appears.