Outstate health officials prepare for hepatitis A cases

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Capital News Service
LANSING — The number of hepatitis A cases related to a Detroit-area outbreak is closing in on 400, prompting some outstate health officials to monitor its spread across Michigan.
It’s not a matter of if it will spread, but when it will spread, said Bay County health officer Joel Strasz.
“We’re talking about a specific strain down there that seems to be more virulent than typical cases of hepatitis A,” Strasz said. “We live in a mobile society and people travel.
“We just anticipate that this is going to come here in some form or fashion,” he said.

Hepatitis A is viral liver disease that can cause yellowing of the skin or eyes, diarrhea, nausea, stomach pain and fatigue.It’s often spread through person-to-person contact and consumption of infected food or water.
Of the 397 cases tied to the Detroit-area outbreak, 320 resulted in hospitalizations and 15 people died. The outbreak dates to Aug. 1, 2016, and has predominantly affected the Metro Detroit area, including Macomb, Monroe, Oakland, Wayne and St. Clair counties.
Ottawa County, which has had two cases of hepatitis A, is monitoring the situation in Detroit and trying to stay vigilant in case the disease were to spread, Kristina Wieghmink, a communications specialist for Ottawa County, said.
Primarily, the county is looking at strands of the disease when cases arise and checking to see if it matches the Detroit-area outbreak. So far, it hasn’t, Wieghmink said.
But since people travel, there is always concern it could spread, Wieghmink said.
Strasz said Bay County is focused on prevention and vaccination,

“Hopefully, it’s not going to come in as great of numbers as what’s happening in Southeast Michigan,” he said. “But we’d like to anticipate that to get as many folks vaccinated as possible.”
People most vulnerable to the disease are heavy drug users, the homeless and males who have sex with males.
Recently, Bay County held an event to vaccinate homeless people.
“They’re a particularly vulnerable population that needs to be targeted,” Strasz said. “Obviously, No. 1, they don’t have homes and in a lot of cases they don’t have a free and adequate supply of sanitary facilities.”
High-stress living conditions of many of the homeless weaken their immune system, leaving them more vulnerable to the disease, he said.
“Those with history of injection and non-injection drug use, homelessness or transient housing, and incarceration are thought to be at greater risk,”Angela Minicuci, the communications director for the Michigan Department of Health and Human Services, wrote in an email.
“No common sources of food, beverages, or drugs have been identified as a potential source of infection associated with this outbreak,” she said.

An additional 42 cases of hepatitis A unrelated to the outbreak have been reported so far in 2017 across multiple counties. Apart from the Detroit-area outbreak, Kent County and Sanilac County reported the most cases with five each. Saginaw, Ingham and Washtenaw counties each registered four cases.
Calhoun, Genesee, Isabella, Lapeer, Livingston and St. Joseph counties all registered three cases. Berrien, Hillsdale, Lake and Ottawa counties all registered two cases.
Only one case was reported in Barry, Bay, Charlevoix, Clare, Clinton, Delta, Eaton, Grand Traverse, Huron, Ionia, Jackson, Kalamazoo, Montcalm and Van Buren counties.
While those cases are not linked to the Detroit outbreak, there is a possibility that strain of the disease will move.
“Diseases do not know boundaries,” Minicuci saidw.
The latest Michigan Disease Surveillance System report shows cases in 34 of Michigan’s 83 counties.
The current tally of all hepatitis A cases in 2017 stands at 439, an increase of 307 from all of 2016.

The  Department of Health and Human Services is targeting potential sources.
“Working with community partners, vaccination efforts are being implemented in targeted locations such as homeless shelters, soup kitchens and rehabilitation facilities,” Minicuci wrote. “Partnerships are also being developed with area emergency departments, county jails and state prisons.”

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