Saturday, August 18, 2018

PRO/EDR> Hepatitis A - USA (36): (KY, OH, IN)

HEPATITIS A - USA (36): (KENTUCKY, OHIO, INDIANA)
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A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

In this update:
[1] Kentucky (Louisville)
[2] Ohio
[3] Indiana

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[1] Kentucky (Louisville)
Date: Thu 16 August 2018
Source: Louisville (KY) Courier-Journal [edited]
<https://www.courier-journal.com/story/news/2018/08/16/hepatitis-fifth-louisville-resident-dies-amid-outbreak/1006250002/>


A 5th Louisville resident has died from hepatitis A, according to the
Louisville health department. The death happened "in the last 5 days
or so," said Dave Langdon, spokesman for the Louisville Metro
Department of Public Health and Wellness. The department did not
release the name or age of the person who died.

Langdon said the number of hepatitis A cases per day has declined to
about one, down from 4.1 in April 2018. "It obviously could go up
before the end of the month," he said. A hepatitis A outbreak was
declared in Louisville in November 2017. As of 14 Aug 2018, there were
580 cases of the disease, with 5 related deaths.

Statewide, there have been 8 deaths and more than 700 hospitalizations
associated with the illness as of 4 Aug 2018, according to the
Kentucky Department for Public Health. The city's health department
said in a news release that it will continue to work to control an
outbreak of acute hepatitis A, which it said has been centered around
the city's homeless population and drug users but others have been
affected as well.

[Byline: Zahria Rogers]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[The total number of cases of acute hepatitis A infections in Kentucky
related to this epidemic as of 4 Aug 2018 was 1341 with new statistics
likely available soon. This number has continued to rise
significantly, with 50 or more newly reported cases per week. The
state could soon have more cases than the 2nd and 3rd highest states
combined. - Mod.LL]

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[2] Ohio
Date: Tue 14 Aug 2018
Source: Fox19 [edited]
<http://www.fox19.com/story/38882833/cases-of-hepatitis-a-increasing-in-clermont-county>


Health officials in Clermont County said they are experiencing an
increase in cases of hepatitis A. The Ohio Department of Health
declared a statewide outbreak of the illness in June 2018. To date [14
Aug 2018], there have been 225 cases reported in Ohio.

Hepatitis A is a virus that affects the liver. It can be spread from
person to person or by eating or drinking food that is contaminated
with the virus. Food can become contaminated with the virus when a
person does not wash their hands after using the bathroom and then
prepares or touches food. Spread of the illness in the current
outbreak is primarily occurring from person to person in high-risk
groups, officials said.

People at higher risk for getting sick from hepatitis A during this
outbreak include people who have direct contact with someone infected
with the virus, men who have sex with men, people who use street drugs
(regardless of whether they are injected), people who are
incarcerated, people experiencing homelessness, and people who have
traveled to areas outside of the US currently experiencing outbreaks.

Symptoms of hepatitis A include fatigue, low appetite, stomach pain,
nausea, clay-colored stools, and jaundice (yellowish color to the skin
and eyes). "We are working with at-risk populations to help prevent
even more people from getting sick," Health Commissioner Julianne
Nesbit said in a news release. "Whether you are considered to be at
high risk or not, anyone can get hepatitis A. So, we encourage
everyone to get vaccinated and wash your hands."

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

******
[3] Indiana
Date: Fri 10 Aug 2018
Source: Indiana State Department of Health [edited]
<https://www.in.gov/isdh/27791.htm>


Since November 2017, the Indiana State Department of Health (ISDH) has
been investigating an outbreak of acute hepatitis A virus (HAV). Cases
have been infected with HAV strains genetically linked to outbreaks
across the US. Indiana has an average of 20 cases of hepatitis A per
12-month period.

Indiana is one of several states experiencing a hepatitis A outbreak,
and outbreak-related cases have been confirmed across the state.
Information on other outbreaks can be accessed from the Centers for
Disease Control and Prevention (CDC) website. Transmission is presumed
to occur person to person; no contaminated commercial food product has
been identified. Based on CDC guidelines, populations who are
homeless, transient, incarcerated, or use illicit drugs and their
close direct contacts are considered at increased risk of exposure to
hepatitis A.

If you believe you have been exposed to hepatitis A or are homeless,
use injection or noninjection drugs, were recently incarcerated, or
had contact with someone who has hepatitis A, contact your healthcare
provider about the hepatitis A vaccine.

To reduce the risk of hepatitis A transmission, people who have not
received 2 doses of hepatitis A vaccine may ask their healthcare
providers for protection. Additionally, always wash your hands with
soap and water after going to the bathroom, after changing diapers,
and before preparing meals for yourself and others. Do not attend work
or school if you are experiencing symptoms of hepatitis A, which
include nausea, vomiting, diarrhea, loss of appetite, tiredness,
stomachache, fever, dark-colored (cola) urine, light-colored stool,
and jaundice (yellowing of skin and eyes). Symptoms may take as many
as 50 days from exposure to appear.

Using the outbreak definition, the ISDH will update this website each
Friday to reflect counties that have 5 or more outbreak-related cases.
The ISDH updated the outbreak definition on 20 Jul 2018 and may
reflect additional cases that were not included in previous outbreak
case counts.

As of 10 Aug 2018: total cases, 364; hospitalized, 161; death, 1.

Date / Cases / Hospitalizations (percentage) / Deaths / Average cases
per week
11 May 2018 / 94 / 46 (49) / 0 / --
6 Jul 2018 / 202 / 93 (46) / 0 / 13.5
13 Jul 2018 / 220 / 101 (46) / 1 / 18
27 Jul 2018 / 298 / 136 (46) / 1 / 39
10 Aug 2018 / 364 / 161 (44) / 1 / 33

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[Those affected the most are the marginalized cohorts of humanity,
including homeless people and substance abusers. Their needs for
adequate sanitation and living conditions were supplied in the San
Diego (CA) area, and such an approach to these outbreaks is required
elsewhere in the USA. Spill-over into other portions of the
population, such as restaurant diners affected through infected food
handlers, will continue. It is not clear how many of this rapidly
increasing total are in individuals outside the described cohorts. -
Mod.LL

HealthMap/ProMED-mail maps:
Kentucky, United States: <http://healthmap.org/promed/p/220>
Ohio, United States: <http://healthmap.org/promed/p/237>
Indiana, United States: <http://healthmap.org/promed/p/217>]

[See Also:
Hepatitis A - USA (35): (KY, TN, IN)
http://promedmail.org/post/20180812.5960616
Hepatitis A - USA (34): (KY, AR)
http://promedmail.org/post/20180808.5952232
Hepatitis A - USA (33) http://promedmail.org/post/20180806.5949411
Hepatitis A - USA (32): (KY)
http://promedmail.org/post/20180731.5939498
Hepatitis A - USA (31): (KY, WV, IN)
http://promedmail.org/post/20180728.5933912
Hepatitis A - USA (30): (WV, AR)
http://promedmail.org/post/20180714.5905424
Hepatitis A - USA (29): (KY, IN)
http://promedmail.org/post/20180713.5903435
Hepatitis A - USA (28) http://promedmail.org/post/20180709.5895266
Hepatitis A - USA (27): (WV, UT, MI)
http://promedmail.org/post/20180702.5885159
Hepatitis A - USA (26): (KY, TN, NC)
http://promedmail.org/post/20180628.5880740
Hepatitis A - USA (25): (OH)
http://promedmail.org/post/20180625.5873183
Hepatitis A - USA (24): (KY, TN, MO)
http://promedmail.org/post/20180621.5860894
Hepatitis A - USA (23): CDC Health Alert Network
http://promedmail.org/post/20180615.5856421
Hepatitis A - USA (22): (KY, NC)
http://promedmail.org/post/20180608.5844690
Hepatitis A - USA (21): update
http://promedmail.org/post/20180531.5830692
Hepatitis A - USA (20): (KY, TN)
http://promedmail.org/post/20180527.5820929
Hepatitis A - USA (19): (MI, UT, IN)
http://promedmail.org/post/20180518.5798559
Hepatitis A - USA (18): (MI, UT, KY)
http://promedmail.org/post/20180512.5792086
Hepatitis A - USA (17) http://promedmail.org/post/20180509.5789924
Hepatitis A - USA (16): (AR, KY, IN)
http://promedmail.org/post/20180503.5780360
Hepatitis A - USA (15): (OH, MI)
http://promedmail.org/post/20180425.5769100
Hepatitis A - USA (14): (KY, WV, UT)
http://promedmail.org/post/20180424.5762837
Hepatitis A - USA (13): (UT, MI)
http://promedmail.org/post/20180406.5729135
Hepatitis A - USA (12): (MI, UT, IN)
http://promedmail.org/post/20180328.5716201
Hepatitis A - USA (11): (KY, IN)
http://promedmail.org/post/20180318.5694916
Hepatitis A - USA (10): (KY, UT, MI)
http://promedmail.org/post/20180307.5671905
Hepatitis A - USA (09): (KY, UT, MI)
http://promedmail.org/post/20180222.5645053
Hepatitis A - USA (08): (WY)
http://promedmail.org/post/20180216.5632464
Hepatitis A - USA (07): (CA, UT, MI)
http://promedmail.org/post/20180215.5629167
Hepatitis A - USA (06): (CA)
http://promedmail.org/post/20180208.5615970
Hepatitis A - USA (05): (MI, UT, CA)
http://promedmail.org/post/20180128.5589100
Hepatitis A - USA (04): (MI, KY)
http://promedmail.org/post/20180115.5559179
Hepatitis A - USA (03): (UT)
http://promedmail.org/post/20180111.5552496
Hepatitis A - USA (02): (CA, MI, UT)
http://promedmail.org/post/20180108.5544747
Hepatitis A - USA: (HI) http://promedmail.org/post/20180107.5543399
2017
----
Hepatitis A - USA (62): (MI, UT)
http://promedmail.org/post/20171231.5530386
Hepatitis A - USA (61) http://promedmail.org/post/20171224.5522033
Hepatitis A - USA (60): (WY)
http://promedmail.org/post/20171223.5521171
Hepatitis A - USA (59): (CA, MI, UT)
http://promedmail.org/post/20171211.5490041
Hepatitis A - USA (58): (KY)
http://promedmail.org/post/20171122.5459962
Hepatitis A - USA (57): (MI, UT) vaccine shortage
http://promedmail.org/post/20171120.5452198
Hepatitis A - USA (56): (MI) western spread
http://promedmail.org/post/20171117.5448927
Hepatitis A - USA (55): (CA, UT)
http://promedmail.org/post/20171116.5445389
Hepatitis A - USA (54): (MI, CA)
http://promedmail.org/post/20171112.5439275
Hepatitis A - USA (53): (CA) fatal
http://promedmail.org/post/20171107.5429761
Hepatitis A - USA (52): (MI) fatal
http://promedmail.org/post/20171106.5426879
Hepatitis A - USA (51): (CA, MI)
http://promedmail.org/post/20171101.5417867
Hepatitis A - USA (50): (CA, CO)
http://promedmail.org/post/20171031.5416392
Hepatitis A - USA (49): (MI) fatal
http://promedmail.org/post/20171030.5413115
Hepatitis A - USA (48): (MI) increase in MSM cases
http://promedmail.org/post/20171027.5408410
Hepatitis A - USA (47): (MI) fatal
http://promedmail.org/post/20171020.5394454
and other items in the archives]
.................................................sb/ll/rd/ml
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