Multi-State Hepatitis A Outbreak

A multi-state hepatitis A outbreak continues to hit the state of Michigan especially hard, as it claimed its 25th life since the outbreak began in August 2016.

In addition, a restaurant worker at a Red Lobster in Novi, MI, tested positive for the contagious virus, potentially exposing an unknown number of employees and customers who ate at the restaurant (27760 Novi Road).

Public health officials and the Michigan Department of Health and Human Services (MDHHS) have recorded 751 cases of hepatitis A illness in Michigan. More than 80 percent of those cases have been severe enough to lead to hospitalization.

Macomb County has seen the most cases (210), followed by the city of Detroit (161), Wayne County (131) and Oakland County (99).

Since the beginning of the outbreak in August 2016, the response by public health officials has included:

• increased health-care awareness efforts
• public notification and education
• outreach with vaccination clinics for high-risk populations.

Identification of common food, beverages, or drugs as a potential source for the infection have been unsuccessful. Transmission appears to be through direct person-to-person contact and illicit drug use.

People with a history of injection and non-injection drug use, homelessness or transient housing, and incarceration are thought to be at higher risk in this outbreak.

The outbreak, which is believed to have started in California, has also affected people from Arkansas, Kentucky, Nevada, New York, Oregon, and Utah. More than 1,600 people have been sickened across the country, and at least 46 people have died.

Multi-state hepatitis A outbreak: A worker at a Red Lobster in Novi, MI, tested positive for hepatitis A, possibly exposing an unknown number of employees and customers who ate at the restaurant.

Multi-state hepatitis A outbreak:
Possible exposure at Red Lobster

Oakland County health officials issued a public health advisory Feb. 16 after a positive test for the hepatitis virus of an employee at the Red Lobster restaurant in Novi.

The restaurant worker potentially exposed people who ate, drank or worked at the Red Lobster from Jan. 15 through Feb. 14.

Hepatitis A is most commonly spread when food and beverages are contaminated during production, or when infected people prepare or serve food.

“Vaccination can prevent the disease, if given within 14 days after potential exposure,” Kathy Forzley, Director of Health & Human Services for Oakland County, said in the advisory. “If you have eaten at this location during these dates and have not been vaccinated for hepatitis A or have a sudden onset of any symptoms, contact your doctor.”

The hepatitis A vaccine is also available through some health-care providers and many pharmacies.

The MDHHS said the following people should be vaccinated:

• People who are homeless.
• People who are incarcerated.
• People who use injection and non-injection illegal drugs.
• People who work with the high-risk populations listed above.
• People who have close contact, care for or live with someone who has the hepatitis A virus.
• People who have sexual activities with someone who has the hepatitis A virus.
• Men who have sex with men.
• Travelers to countries with high or medium rates of the hepatitis A virus.
• People with a chronic liver disease, such as cirrhosis, hepatitis B, or hepatitis C.
• People with clotting factor disorders.

Most children in the United States have been receiving hepatitis A vaccinations since the preventative measure became a recommended standard in 2006. The vast majority of adults have not been vaccinated, even though it has been available since 1996.

Multi-state hepatitis A outbreak:
What is hepatitis A?

Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus, according to the Mayo Clinic. The virus is one of several types of hepatitis viruses that cause inflammation and affect your liver’s ability to function.

Hepatitis A usually spreads when a person unknowingly ingests the virus from objects, food, or drinks contaminated by small, undetected amounts of stool (i.e. feces) from an infected person, according to the Centers for Disease Control and Prevention.

Also, the virus spreads from person to person with unclean hands contaminated with feces, during sex, or just by associating with an infected person.

Mild cases of hepatitis A don’t require treatment. Most people who are infected recover thoroughly with no permanent liver damage.

Practicing good hygiene, including washing hands frequently, is one of the best ways to protect against hepatitis A. Vaccines are available for people most at risk.

Multi-state hepatitis A outbreak:
What are the symptoms?

Signs and symptoms of hepatitis A typically don’t appear until you have had the virus for a few weeks. Not everyone with hepatitis A develops symptoms, however. The incubation period of hepatitis A is usually 14 to 28 days.

Signs and symptoms can include:

• fatigue
• sudden nausea and vomiting
• abdominal pain or discomfort, especially on the upper right side beneath the lower ribs (by the liver)
• clay-colored bowel movements
• loss of appetite
• low-grade fever
• dark urine
• joint pain
• jaundice (yellowing of the skin and the whites of the eyes)
• intense itching.

Symptoms may be relatively mild and go away in a few weeks. Sometimes, however, hepatitis A infection results in a severe illness that lasts several months.