Hepatitis A outbreak worst ever; Ky. leads the nation; state health commissioner advises Kentuckians to wash hands, get vaccinated

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State health officials say the hepatitis A outbreak in Kentucky is the worst ever, and the crisis isn't over.

"It's the worst on record across the nation and in Kentucky," Dr. Jeff Howard, Kentucky Commissioner of Public Health, told Beth Warren of the Louisville Courier Journal.

Kentucky health officials have confirmed 969 cases and six deaths from the highly contagious liver disease. No other state has reported as many.

Warren notes that Louisville has been the hardest hit, with 480 cases and three deaths. The other deaths were in Ballard, Meade and Greenup counties. Kentucky normally only has about 20 hepatitis A cases a year.

The state Department for Public Health reports that most of the cases have been among the homeless and drug users. So far, there haven't been any food-related transfers of hepatitis A, but it's a major fear.

"Sharing a home, a cigarette, marijuana joint, a drink, or sex with someone who has the virus puts you at high risk," according to an advisory website in Louisville, Warren notes.

The health department's weekly hepatitis A outbreak report, which was last updated on June 16, shows that Bell, Breathitt, Butler, Edmonson, Johnson and Washington counties have identified their first cases since August of last year.

Health officials urge people who live in counties with an outbreak, and those who are in high-risk groups, to get vaccinated against hepatitis A. They also encourage people who work in food preparation and service to get immunized. Immunization requires two vaccines, six months apart.

Public schools across Kentucky require students to get the vaccine before starting school this year.

Besides Jefferson County, the 11 other counties reporting five or more cases are: Ballard, Grayson, Ohio, Rowan, Shelby, Whitley, Fayette, Powell, Lincoln, Grant and Bourbon.

Officials are also encouraging everyone to wash their hands for about 20 seconds with soap and water after using the bathroom, before they eat, and when they get home from being out in public, adding that hand gels are not an alternative because they don't kill the virus.

Warren tells the story of a Louisville woman who is one of the 10 percent of people in Louisville who got the virus but was not in a high-risk group.

Angela Glotzbach, a medical sales representative, told Warren that she was "baffled" by her diagnosis and described being sick for three months as "1,000 times worse than the flu."

"Dehydration from vomiting and diarrhea sent her to the hospital three times and she suffered tremors, joint and back pain, fatigue and trouble forming sentences," Warren writes.

The most common symptoms of hepatitis A are fatigue, low-grade fever, loss of appetite, joint pain, sudden nausea and vomiting, yellow eyes or skin, abdominal pain, pale stools and dark urine. A person with the virus is contagious for up to two weeks before showing symptoms and one week after. Symptoms usually last less than two months, but 10 percent to 15 percent of victims remain sick for up to six months.

Dr. Paul Schulz, infectious diseases specialist and system epidemiologist for Norton Healthcare, told Warren that it's unlikely that most adults got the vaccine as a child unless they traveled abroad or were in a high-risk population because it wasn't available until 1995, and wasn't added to the child immunization schedule until 1999. He added that a health care provider can perform a simple blood test to see if someone has been vaccinated or has immunity.