CINCINNATI, Ohio – In June 2017, the Ohio Department of Health declared a Hepatitis A outbreak as cases across Ohio started to rise.
- There were 1,311 reported cases of Hepatitis A in Ohio in 2018
- Butler County has the highest number of cases
- 66 of Ohio's 88 counties reported at least one Hepatitis A case last year
Ohio typically averages a few dozen cases per year, but at the end of 2018, there were more than 1,300 reported cases.
Butler, Montgomery, Franklin and Hamilton counties reported the highest number.
Hepatitis A is a contagious disease of the liver. Symptoms can include stomach pain, fatigue, jaundice, nausea and vomiting, and diarrhea.
A nationwide outbreak first occurred in the western U.S. and slowly spread east last year.
“We are facing an epidemic and the best that I can relate it to is the opioid crisis,” said Mercy Health Regional Manager for Infection Prevention Jan Miller.
Miller says despite the high number of cases at Mercy Health hospitals throughout southwest Ohio, the number of positive tests in December at the hospital's Fairfield location did drop.
“December we started to see those number of cases of Hepatitis A that are diagnosed come down. We are still continuing to see patients that are opioid addicted or have drug-seeking behaviors come through the emergency departments.”
Hepatitis A is transmitted fecal-oral, meaning someone ingests the virus through a person's waste. Often, that is a result of poor hygiene. Someone who is infected doesn't wash their hands thoroughly and can transmit the disease.
Often, it can be transmitted through food and drink at restaurants, but Hamilton County Public Health Commissioner Tim Ingram says few cases in Hamilton County were at restaurants.
Public health officials always warn the public about contamination at restaurants. Still, a majority of Hepatitis A cases in Hamilton County are through intravenous drug use.
“The main risk category we've seen is among the injectable drug use population,” said Ingram to Spectrum News 1. “But again, we have to be very careful because some of the folks that are suffering and fighting this disease of opioid addiction, they're working also in restaurants and other places trying to make ends meet until we can get those folks into treatment or they're ready to go into treatment to try and get them into remission."
Ingram said the general public doesn't have anything to worry about while eating out, but he still warns that vaccination and proper hand washing can prevent transmission.
The Hepatitis A vaccine takes place in two stages, but Miller said even one vaccine is about 93 percent effective. Mercy Health and other healthcare providers have taken efforts to vaccinate individuals who enter their emergency rooms because of drug overdoses or other health problems.
“We are trying to get the vaccine more widely available,” Miller said. “Making it free to that population. When those people in those risk groups present at a healthcare facility, we're trying to vaccinate them.”
Several counties have provided Hepatitis A vaccinations to people incarcerated in jail. Jail staff and sheriff's deputies have also been vaccinated because they come into close contact with risk groups associated with Hepatitis A.
Ingram said most of the Hepatitis A cases in Hamilton County required hospitalization because symptoms became so severe. He was not aware of any deaths in the county as a result of Hepatitis A. However, Ohio did report four fatalities from Hepatitis A in 2018.
Ohio joins neighboring states that have also experienced an outbreak: Indiana, Kentucky, Michigan, Pennsylvania, and West Virginia.
66 of Ohio's 88 counties reported at least one Hepatitis A case in 2018. By declaring an outbreak, Ohio receives assistance from the CDC and access to additional vaccinations.
Both Ingram and Miller say vaccination and daily hand washing – and not just before or after meals, is the easiest way to prevent contracting Hepatitis A.