Sunday, April 29, 2018

Hepatitis A outbreak prompts warning in Ind. about travel to Ky., where state health commissioner pushes back; drugs play a role

The increasing number of hepatitis A cases in Kentucky has prompted the state health commissioner to do a video saying it's safe to visit the state, and has focused new attention on the role of drug abuse in the outbreak.

Kentucky officials have confirmed almost 400 cases of the liver disease since they declared an outbreak last summer. The annual average is about 20 cases.

Indiana health officials "told Hoosiers heading to Kentucky to get a hep-A vaccine," prompting acting Commissioner for Public Health Jeffrey Howard to push back. “Let me say that it IS safe to travel to Kentucky, and it IS safe to attend the Kentucky Derby,” Howard said in a YouTube video.

"What had looked like an isolated rash of cases in a few Kentucky counties has now become a multi-state, regional outbreak, with nearly 500 cases in four states and the numbers rising daily," Mary Meehan reports for Ohio Valley ReSource. "As with recent clusters of cases of HIV and elevated risk of Hepatitis C, this latest outbreak of hep A is also closely linked to the region’s addiction crisis."

That is unusual, Meehan reports: "Usually, Hep A outbreaks are caused by ingesting food contaminated with fecal matter. That often means the food is contaminated where it is grown or that a food service worker unwittingly passes on the disease through a restaurant."

West Virginia Health Commissioner Rahul Gupta told Meehan, “Individuals who may have substance use disorder and may be using illicit drugs may also not be able to keep up personal hygiene,” he said, “which puts them at higher risk for being infected with Hepatitis A.”

Howard said, "The biggest challenge we face is when outbreaks cross state lines,” noting a cluster of HIV cases in Northern Kentucky and Cincinnati linked to intravenous drug use. “For the first time in the history of Kentucky, we had HIV transmission with the most common risk factor being intravenous drug use,” he said. “We will see more and more outbreaks in the upcoming months and years.”

Death from hepatitis A is relatively rare, but the illness can be severe and last several weeks, Meehan reports: "Symptoms include``fever, fatigue, nausea, vomiting, dark urine, jaundice, clay-colored bowel movements and joint pain. . . . The best prevention is a good hand wash with soap and water."

Ohio Valley ReSource map

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