By Brenda Keller, CNP
Gastroenterology Associates of Northwest Ohio
Outbreaks of hepatitis A are taking place in several states throughout the country, including our neighboring states of Indiana, Kentucky, Michigan and West Virginia.

In Ohio, the greater Cincinnati area is leading the state in the number of confirmed hepatitis cases. The Ohio Department of Health (ODH) declared a statewide community outbreak of hepatitis A after observing an increase in cases linked to certain risk factors since the beginning of 2018.

According to statistics provided by the ODH, the following is a summary of the hepatitis A outbreak through March 18, 2019:

• Number of cases between January 5, 2018 and March 15, 2019: 1,979
• Age range: 1-84 years
• Gender: 60 percent male
• Number of hospitalizations: 1,222 (62 percent)
• Number of deaths: 7
• Number of (Ohio) counties with cases: 72 (82 percent)

Hepatitis A is a vaccine-preventable liver disease. The virus usually spreads when a person ingests food or beverages contaminated by the stool of an infected person. This is an example of why handwashing is so important!

Hepatitis A can also be spread through close personal contact with an infected person, such as through sexual intercourse.

Symptoms of hepatitis A include fatigue, decreased appetite, abdominal pain, jaundice and clay-colored stools. Hepatitis A can result in an illness that ranges from mild, lasting only a few weeks, to severe, lasting several months. In more severe cases, hospitalization may be required.

Persons at risk for hepatitis A include the following:

• People with direct contact with individuals infected with the virus
• Men who have sex with men
• People who use street drugs (whether they are injected or not)
• Individuals who are incarcerated
• Persons who are homeless
• People who have traveled to other places currently experiencing outbreaks

Individuals who believe they are at high risk for a hepatitis A infection should contact their health care provider or local health department for information about vaccination. People who know they have been exposed to someone with hepatitis A should contact their health care provider or local health department to discuss post-exposure vaccination plans.

The diagnosis of hepatitis A is based on clinical and laboratory criteria. The clinical criteria include an acute illness with any sign or symptom consistent with acute viral hepatitis and either jaundice or elevated AST or ALT levels. The laboratory criteria include a positive IgM antibody to hepatitis A virus (anti-HAV) or nucleic acid amplification test (NAAT) for hepatitis A virus positive (including PCR or genotype testing).

Prompt reporting and treatment is important in curtailing the virus. Eliminating risk factors is the most critical component of avoiding the kind of “A” that nobody wants.