The Ohio Department of Health (ODH) has declared a statewide community outbreak of hepatitis A after observing an increase in cases linked to certain risk factors. Ohio is reporting 79 hepatitis A cases associated with the outbreak so far this year, almost double the number of cases reported during all of last year.
 
Hepatitis A outbreaks are occurring in several states across the U.S., including the neighboring states of Indiana (138 cases), Kentucky (761 cases), Michigan (843 cases) and West Virginia (248 cases). A number of Ohio’s hepatitis A cases have been linked to these outbreaks.


 
Hepatitis A is a vaccine-preventable liver disease that usually spreads when a person ingests fecal matter—even in microscopic amounts—from contact with objects, food or drinks contaminated by the stool of an infected person. Hepatitis A also can spread from close personal contact with an infected person, such as through sex.
 
“Good hand-washing and vaccination are the best ways to prevent hepatitis A in at-risk individuals,” said Sietske de Fijter, state epidemiologist and chief of the ODH Bureau of Infectious Diseases. “If you or someone you know has one or more risk factors for hepatitis A, call your local health department to see about getting vaccinated.”
 
ODH has provided more than 5,000 doses of hepatitis A vaccine to local health departments. Declaring a hepatitis A outbreak ensures ODH access to additional hepatitis A vaccine through the federal Centers for Disease Control and Prevention.
 
People at increased risk for hepatitis A include those who have direct contact with individuals infected with the virus; travelers to countries where the virus is prevalent; men who have sex with men; people who use street drugs whether they are injected or not; people with blood-clotting factor disorders; people with chronic liver disease; and household members and other close contacts of adopted children newly arrived from countries where hepatitis A is common.

Ohio’s hepatitis A outbreak cases appear to be primarily among people who use illegal drugs, those who have been incarcerated, people who have had contact with known cases, those also infected with hepatitis C, men who have sex with men and people experiencing homelessness.
 
ODH has sent a health alert to all local health departments across the state with guidance on investigating hepatitis A cases and identifying high-risk groups for vaccination. ODH also is encouraging healthcare providers and others who interact with people seeking care to evaluate them for vaccination based on their risk factors for hepatitis A and to provide vaccination or refer them to the local health department for vaccination when appropriate.
 
Local health departments are investigating all hepatitis A cases within their jurisdictions. Public health workers interview people diagnosed with hepatitis A to identify other individuals who may have been in close contact with them. The public health workers assess these individuals to determine whether they should receive post-exposure vaccination as a precaution so that they don’t get the hepatitis A virus and spread it to others.
 
Symptoms of hepatitis A include fatigue, low appetite, stomach pain, nausea, clay-colored stools and jaundice. People with hepatitis A can experience mild illness lasting a few weeks to a severe illness lasting several months.