Hepatitis A Outbreak

Hepatitis A Overview

Hepatitis A is a short-term viral infection causing inflammation of the liver. Infection can be prevented by receiving the hepatitis A vaccine. Most people who get hepatitis A feel sick for several weeks, but they usually recover completely and do not have lasting liver damage. Many children and adults who become infected never develop symptoms, but for those who do, symptoms usually develop two to six weeks after being exposed. Symptoms include fever, stomach pain, nausea or vomiting, diarrhea, dark urine and yellow skin (jaundice).

How is hepatitis A infection spread?  

Most people get hepatitis A by person-to-person contact with someone who has the infection or through eating or drinking food or water contaminated by an infected person. People can also get hepatitis A through sex or by close contact with an infected person, such as a household member.

Certain adults who may be at higher risk for hepatitis A include:

  • People who use injection or non-injection drugs
  • People who are homeless
  • People who are or recently were incarcerated
  • Men who have sex with men
  • People who are traveling to countries where hepatitis A is common

NOTE: People with chronic liver disease such as cirrhosis or hepatitis B or C are at increased risk of complications if infected with hepatitis A. 

What if I think I have hepatitis A infection? 

If you think you may have hepatitis A, see your medical provider. A blood test determines if someone has a hepatitis A infection. There is no specific treatment for hepatitis A. Your doctor might provide treatment to lessen symptoms. Those with severe illness may need to be placed in the hospital for care as they recover. Hepatitis A is a reportable condition, meaning a medical provider is required to report a confirmed case of the illness to DHEC. If you have hepatitis A, please follow treatment and preventative measures recommended by your medical provider to help reduce the risk of spreading the illness.

What can people do to protect themselves and their communities?

Get vaccinated against hepatitis A. The hepatitis A vaccine is the best form of protection! Wash your hands after using the restroom and before eating or preparing meals for yourself or others.

Who should get the hepatitis A vaccine?

All children aged 12 months to 18 years are recommended to get two doses of the hepatitis A vaccine. 

Adults who were not vaccinated as children may be vaccinated at any time. 

Certain adults who may be at higher risk for hepatitis A infection should be vaccinated, including:

  • People who use injection or non-injection drugs
  • People who are homeless
  • People who are or recently were incarcerated
  • Men who have sex with men
  • People with chronic liver disease like cirrhosis, hepatitis B or C
  • People who are traveling to countries where hepatitis A is common
  • People with chronic liver disease like cirrhosis, hepatitis B or C as they have an increased risk of complications if infected with hepatitis A

Where can people get the hepatitis A vaccine?

Talk to your medical provider about the hepatitis A vaccine. In South Carolina, adults 18 years and older can get vaccinated at some local pharmacies without a prescription, depending on your insurance coverage. To search for a nearby pharmacy that offers vaccines, visit www.vaccinefinder.org.

DHEC’s local health departments also provide hepatitis A vaccines. DHEC has an Adult Vaccine Program that provides low-cost vaccines for uninsured or underinsured individuals who are 19 years and older.

DHEC’s local health departments are currently providing no-cost hepatitis A vaccines to individuals in at-risk groups (drug users, homeless, recently incarcerated, and men who have sex with men).

To schedule an appointment for vaccination at your local health department, call 855-472-3432 or visit www.scdhec.gov/health/health-public-health-clinics.

Hepatitis A Outbreak in South Carolina

Hepatitis A cases began to increase in South Carolina in fall 2018. An outbreak of hepatitis A was declared in Aiken County on Feb. 13, 2019 and DHEC declared a statewide outbreak on May 13, 2019. This outbreak coincides with a national hepatitis A outbreak that began in 2016. Cases have occurred primarily among three risk groups: people who use injection or non-injection drugs, people experiencing homelessness, and men who have sex with men.

Outbreak - Associated Hepatitis A cases in South Carolina (November 1, 2018 – December 1, 2019)

Outbreak-associated hepatitis A data are as follows:

  • Total number of cases = 630
  • Hospitalizations = 383 (61%)
  • Deaths = 1* (<1%)
    Note: *Hepatitis A deaths are not a reportable condition; death counts may not be accurate.
Map of Confirmed Hepatitis A Cases Dec. 2, 2019

Note: The colors used to display case counts by Region and the groups used for case counts have been changed, as referenced in the key.

Graph of Confirmed Hepatitis A Cases Dec. 2 , 2019

Possible Exposures At Restaurants

DHEC investigates all reports of hepatitis A in South Carolina. The risk of hepatitis A being spread by a food handler to people who eat at a restaurant is low. Preliminary findings of a survey conducted by the Centers for Disease Control and Prevention (CDC) found that of more than 25,000 hepatitis A cases reported during this nationwide outbreak, less than 4 percent were among food handlers. The CDC, which is finalizing its study to quantify the extent to which secondary infections have occurred, found that less than 60 cases (well below 1 percent) have been reported of people infected from exposure in a US restaurant where a worker tested positive. In South Carolina, 6 percent of the more than 500 hepatitis A cases have been among food handlers; no secondary infection has been verified at a restaurant in our state.
 
At the start of the South Carolina hepatitis A outbreak, DHEC — out of an abundance of caution — continued an established practice of giving public notice when a restaurant food handler tested positive. After reviewing updated guidance provided by the Centers for Disease Control and Prevention as well as data and other information related to the outbreak in South Carolina, DHEC no longer gives public notification every time a restaurant worker tests positive for hepatitis A. Based on recognized best practices from the CDC and other states, when an investigation shows the likelihood of patrons being exposed is small and hepatitis A vaccine is not needed, no public notice will be given. Notices will be posted on this website if it is recommended patrons should consider hepatitis A vaccine.

 

Sept.17, 2019: Waffle House, S. Goose Creek Blvd. Berkeley County


References and additional information

Tags

Infectious Diseases Viral Hepatitis