The Lake County Health Department alerted the public Friday February 1, 2019 that over the past year there has been an increase in reported cases of hepatitis A virus (HAV) in the state and in Lake County. Since January 2018, the Illinois Department of Public Health (IDPH) has confirmed 110 cases and has identified 35 cases to be part of a statewide outbreak in Illinois. HAV is highly contagious and is a vaccine-preventable infection.
In the February 1, 2019 release, the Lake County Health Department did not release specific statistics for Lake County, Illinois.
States near Illinois have also reported large hepatitis A outbreaks, according to the IDPH.
Indiana reported over 700 cases from September 2017 to mid-December 2018.
Kentucky reported over 3,000 cases from August 2017 to mid-December 2018.
Missouri reported over 200 cases from September 2017 to mid-December 2018.
Illinois HAV cases were only slightly above average in 2018, but there were accelerated numbers of news cases in late November through mid-December 2018.
Symptoms include fever, tiredness (fatigue), loss of appetite, nausea, vomiting, abdominal and joint pain, dark urine, gray or clay-colored stools, and jaundice (yellowing of skin and eyes).
About 10–15% of people experience a recurrence of symptoms during the six months after the initial infection. Acute liver failure may rarely occur, but this is more common among elderly patients.
No specific treatment is available for HAV infection, except rest and medications for nausea or diarrhea, which are recommended on an as-needed basis. Infections usually resolve completely without ongoing liver disease. However if acute liver failure develops, the treatment is liver transplantation.
“We encourage any resident who is exhibiting symptoms of HAV to seek medical attention immediately. We also encourage residents at high-risk for infection to get vaccinated for hepatitis A.”
— Dr. Sana Ahmed, of the Lake County Health Department
Once infected by HAV, there is a two- to seven-week incubation period before a person exhibits symptoms of infection. Anyone experiencing symptoms of HAV should call their healthcare provider to get tested. Anyone who has close contact with a person who has been recently infected with HAV should also get vaccinated.
Hepatovirus A is present in the blood (viremia) and feces of infected people up to 2 weeks before clinical illness develops.
A person might become infected with HAV when there is unknown consumption of contaminated food or drink prepared by or served by an infected person. A person may also become infected by direct contact with an infected person.
Groups with high risk for HAV infection include …
men who have sex with men,
people who are homeless,
people who are incarcerated,
both injection and non-injection drug users,
people with direct contact with someone who has HAV,
and travelers to countries where HAV is common.
The IDPH recommends the following steps to prevent HAV:
Get vaccinated
Wash hands thoroughly with soap and water
Do not share needles or have sex with someone who has hepatitis A
Do not share food, drinks, or cigarettes
Do not share eating utensils or personal items
In an effort to prevent additional hepatitis A cases in Illinois, IDPH is working with 38 local health departments around the State of Illinois, covering 41 counties to make hepatitis A vaccine more readily available. In early September 2018, IDPH requested a large number of hepatitis A vaccines from the Centers for Disease Control and Prevention (CDC). That vaccine is being delivered to local health departments to be available for free or at a reduced cost. Men who have sex with men, people who use drugs, and people who do not have a home should check with their health department about a free or reduced cost hepatitis A vaccine.
Who should get vaccinated against hepatitis A (according to CDC)?
The Advisory Committee on Immunization Practices (ACIP) recommends hepatitis A vaccination for the following people:
All children at age 1 year
Travelers to countries where hepatitis A is common
Family and caregivers of adoptees from countries where hepatitis A is common
Men who have sexual encounters with other men
Users of recreational drugs, whether injected or not
People with chronic or long-term liver disease, including hepatitis B or hepatitis C
People with clotting-factor disorders
People with direct contact with others who have hepatitis A
Any person wishing to obtain immunity (protection)
CDC: “Safe Vaccine”
According to the CDC, the hepatitis A vaccine is safe and effective and given as 2 shots, 6 months apart. Both shots are needed for long-term protection. The hepatitis A vaccine also comes in a combination form, containing both hepatitis A and B vaccine, that can be given to anyone 18 years of age and older. This combination vaccine is given as 3 shots, over 6 months. All three shots are needed for long-term protection for both hepatitis A and B.
According to the CDC, the hepatitis A vaccine is highly effective in preventing hepatitis A virus infection. A second hepatitis A vaccine shot results in long-term protection.
According to the CDC, the hepatitis A vaccine no serious side effects have been reported from the hepatitis A vaccine. Soreness at the injection site is the most common side effect reported. As with any medicine, there is always a small risk that a serious problem could occur after someone gets the vaccine. However, the potential risks associated with hepatitis A are much greater than the potential risks associated with the hepatitis A vaccine. Since the licensure of the first hepatitis A vaccine in 1995, millions of doses of hepatitis A vaccine have been given in the United States and worldwide.
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There are three vaccines available:
Havrix® manufactured by by GlaxoSmithKline
Vaqta® for pediatric patients manufactured by Merck & Co.
Twinrix® (for Hepatitis A and Hepatitis B) by GlaxoSmithKline
Short term protection is also available — especially for travelers in high risk areas — via an immune globulin (IG) shot, which is a substance made from human blood plasma that contains antibodies that protect against infection. Immune globulin (IG) provides short-term protection against hepatitis A for up to 2 months depending on the dosage given, and is sometimes used before travel to a country where hepatitis A is known to be prevalent. IG is also used to prevent infection after known exposure to the hepatitis A virus, but must be given within 2 weeks after exposure for the best protection.
According to the CDC, GamaSTAN® is the only available hepatitis A immune globulin product in the United States, as of June 5, 2013. Grifols, S.A. — a Spanish multinational pharmaceutical and chemical manufacturer that produces of blood plasma-based products — produces GamaSTAN®.
See also …
cdc.gov/hepatitis/hav/index.htm