Florida hepatitis A outbreak spreading; most patients are non-Hispanic whites

foodsafetynews 2019-02-11

Tag: Florida non-Hispanic whites patients

Florida officials report the state’s hepatitis A outbreak count for January showed 189 confirmed cases confirmed across 26 counties. The central Florida region had the highest hepatitis A activity levels in the state this past month.

The number of reported hepatitis A cases more than doubled from 2016 to 2017 after remaining relatively stable in previous years, according to the Florida Health Department. The case count in January this year was higher than those seen in January in previous years. Most of the cases in January this year, 77 percent, were among people who self-identify as “non-Hispanic white,” according to the Florida report.

“The number of reported hepatitis A cases steadily increased each month since April 2018 and remained above the previous 5-year average in January 2019. The number of cases reported in January increased from the previous month,” according to the department’s update.

“Since Jan. 1, 2018, 516 (for 73 percent) cases likely acquired in Florida have been hospitalized because of their hepatitis A infection, and five cases have died as a direct result of hepatitis A infection.”

Other details from Florida’s report include:

From January 2018 to January 2019, a fourth of the 736 total cases, 185, were epidemiologically linked to other cases.
In January 2019, 37 percent of cases were linked to other cases.
Of the 69 linked cases in January 2019, 20 were linked to another case by household contact, 15 cases by environmental contact, 5 cases by sexual contact, 8 cases by personal contact, 1 case by other contact, and 20 cases had an undetermined relationship.
Since Jan. 1, 2018, the incidence rate was highest among adults aged 30-39 years old at 9.4 cases per 100,000 population.
In January 2019, the incidence rate was again found to be highest among adults aged 30-39 years old at 2.4 cases per 100,000 population.
Since Jan. 1, 2018, two-thirds of Florida’s reported cases were male.
Since Jan. 1, 2018, the vast majority of infections in the Sunshine State, 97 percent, have likely been acquired locally.

“Since Jan. 1, 2018, 97 percent of people with hepatitis A had never received a documented dose of hepatitis A vaccine. In January 2019, 95 percent of infected people had not received the vaccine,” according to the Florida report.

At least 15 states have been fighting hepatitis A outbreaks since March 2017. The U.S. Centers for Disease Control and Prevention has been tracking the outbreaks, but the federal agency hasn’t posted a comprehensive updat for several months.

In June 2018 the CDC renewed a public health advisory urging health care providers to watch for potential cases and encouraging the public to seek vaccination.

Public health investigators across the country have not found a common source of the infections, but more than 70 percent of the victims in many areas are homeless people, substance abusers, or both. There is a post-exposure treatment, but it is only effective if given within two weeks of exposure.

Most people infected with the hepatitis A virus are contagious before symptoms develop. The virus can be spread when infected people handle, prepare or serve foods and beverages.

Many restaurants wher infected workers have been detected during the ongoing outbreak have voluntarily offered post-exposure vaccinations for customers. There are currently a number of civil lawsuits in state and federal courts seeking reimbursement for restaurant customers who had to miss work and pay for post-exposure vaccinations.

The CDC recommends routine vaccination for:

All children at age 1 year;
People traveling to or working in countries that have high or intermediate endemicity of hepatitis A;
People who have infected household members are in close personal contact with infected people;
People interacting with adopted children newly arriving from countries with high or intermediate hepatitis A endemicity;
Men who have sex with men;
People who use injection and non-injection drugs;
People who have occupational risk for infection;
People who have chronic liver disease;
People who have clotting-factor disorders; and
Anyone wishing to obtain immunity.