January 18, 2018 at 3:57 p.m.
Hepatitis A outbreak hits Michigan
By Kim Walker-
According to the Michigan Department of Health and Human Services, as of Jan. 10, there were 677 confirmed cases of outbreak related Hepatitis A, and of those, 554 have been hospitalized. Twenty-two deaths have been reported, mostly occurring in Detroit and surrounding areas.
This current outbreak began in San Diego and is responsible for 686 cases and 21 deaths in that state. It migrated to Utah where, as of Jan. 8, 133 outbreak-related cases were confirmed. CNN reports 97 of those cases stemmed from a food service employee at a 7-Eleven convenience store in Salt Lake County and according to The Salt Lake Tribune, those who visited Spanish Fork Olive Garden or the Sonic Drive-In restaurant in that region during the last week of December were also potentially exposed to the disease. What is this latest viral outbreak and should we be concerned?
Clinical features
Hepatitis A is a highly infectious liver disease caused by a virus transmitted via a fecal-oral route. People can be infected by contaminated food or water, sex, illicit drug use or close contact with someone infected.
Symptoms appear 15-50 days after exposure and can include nausea, vomiting, fatigue, yellowing of eyes and skin, loss of appetite, dark urine and joint pain. Although most people infected recover from the illness, it can cause death due to liver failure.
This particular Genotype (Genotype IB) of Hepatitis A is normally not found in the U.S. but is more common in the Mediterranean, South Africa and Turkey. It is this genotype that is more associated with liver failure in those infected, especially individuals who have underlying medical issues.
Prevention
A vaccine is available for Hepatitis A and is effective against all strains of the virus, however, due to the recent outbreak, there is a national shortage of the vaccine and current CDC protocol is to inoculate those who are most at risk.
For those who are unimmunized and exposed to the virus, the CDC updated recommendations on post-exposure immunization stating that if the vaccine is given within two weeks of exposure it acts as a preventative in 80-90 percent of cases.
Other ways to prevent infection is to wash hands thoroughly after using the bathroom and before preparing food, especially if you work in the food service industry. Avoid illicit drug use, sex with infected individuals and not sharing food, drinks or personal care items with those infected. According to the CDC. the virus can live for months outside the body on surfaces and hand sanitizers are ineffective at killing it. The virus is also not killed easily by some cleaners and it is recommended to use bleach-based products to clean and sanitize surfaces.
Should we be concerned?
ABC News reports that this outbreak is different, according to the interview with Dr. Matt Zahn, director of epidemiology at Orange County Health Care Agency(California).
"Previously, we have seen outbreaks that are food-borne, with direct exposure to that food source. Ongoing person-to-person spread is really not something we have seen in recent years." Zahn states.
Mostly circulating in the homeless population, it has now crossed over to the general population most likely due to food-borne contamination. Transient individuals are vulnerable to viral diseases such as Hepatitis A, due to their living conditions and higher rate of underlying medical problems.
In the case of the 7-Eleven employee, the virus was contracted when the worker came into contact with an infected homeless person. Some advocates say this is a call-to-action for government officials to address the rampant homeless problem occurring in the U.S. Until causative factors of this outbreak are brought under control, vaccination and/or frequent and thorough hand washing as well as exemplary sanitary procedures in and around the preparation of food is the key to halt the spread of this virus.
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