Michigan Hepatitis A Outbreak

Public health officials and the Michigan Department of Health and Human Services (MDHHS) are continuing to see an elevated number of hepatitis A cases in the state.

Since the beginning of the outbreak in August 2016, public health response has included increased healthcare awareness efforts, public notification and education, and outreach with vaccination clinics for high-risk populations.No common sources of food, beverages, or drugs have been identified as a potential source of infection. Transmission appears to be through direct person-to-person spread and illicit drug use. Those with history of injection and non-injection drug use, homelessness or transient housing, and incarceration are thought to be at greater risk in this outbreak setting. Notably, this outbreak has had a high hospitalization rate.



Michigan Hepatitis A Outbreak Cases and Deaths as of February 5, 2020*

*Table will be updated weekly by 4:00pm each Friday

Cases Hospitalizations Deaths 920 738 (80.2%) 30 (3.3%)

Please note: Table does not include all reported hepatitis A cases in the outbreak region; only those cases that are identified as outbreak-related. More descriptive data on the current outbreak can be found within the Comprehensive Summary. Data are provisional and subject to change.

Confirmed Cases Referred August 1, 2016 - February 5, 2020

Meeting the MI Hepatitis A Outbreak Case Definition County (or city) Total Cases County (or city) Total Cases Macomb† 223 Gratiot† 3 City of Detroit† 173 Midland† 3 Wayne† 164 Allegan† 2 Oakland† 120 Cass† 2 St. Clair† 33 Mecosta† 2 Ingham† 30 Bay† 1 Genesee† 28 Charlevoix† 1 Shiawassee† 22 Clare† 1 Washtenaw† 20 Hillsdale† 1 Monroe† 18 Huron† 1 Calhoun† 10 Ionia† 1 Isabella† 8 Leelanau† 1 Lapeer† 7 Lenawee† 1 Clinton† 6 Missaukee† 1 Livingston† 6 Newaygo† 1 Sanilac† 6 Schoolcraft† 1 Eaton† 6 St Joseph† 1 Saginaw† 5 Van Buren† 1 Grand Traverse† 4 Other*† 2 Kent† 4 † Indicates no confirmed case in the past 100 days *Jackson Michigan Department of Corrections Indicates counties with outbreak-associated cases that are not currently included in the outbreak jurisdiction

Hepatitis A Overview

Hepatitis A is a serious, highly contagious liver disease caused by the hepatitis A virus (HAV). HAV is found in the feces (poop) of people with hepatitis A. You can get hepatitis A by eating contaminated food or water, during sex, or just by living with an infected person. Illness can appear 15-50 days after exposure and you can be sick for several weeks. In some cases, people can die. Although not all people infected with hepatitis A experience illness, symptoms can include:

nausea and vomiting

nausea and vomiting belly pain

feeling tired

fever

loss of appetite

yellowing of the skin and eyes

dark urine

pale-colored feces (poop)

joint pain

There are steps you can take to reduce the risk of Hepatitis A transmission. Hepatitis A is a vaccine-preventable illness. While the hepatitis A vaccine is recommended as a part of the routine childhood vaccination schedule, most adults have not been vaccinated and may be susceptible to the hepatitis A virus. The best way to reduce the risk of getting hepatitis A is to get vaccinated with two doses of Hepatitis A vaccine. It is also recommended to wash your hands after going to the bathroom and before preparing meals for yourself and others. Use your own towels, toothbrushes, and eating utensils. Do not have sex with someone who has HAV infection or share food, drinks, or smokes with other people.

What can the public do to protect themselves and their communities?

Get vaccinated against hepatitis A

Wash hands after using the restroom and before eating or preparing meals for yourself or others

Use your own towels, toothbrushes, and eating utensils

Do not have sex with someone who has HAV infection

Do not share food, drinks, drugs, or smokes with other people

If you think you may have hepatitis A, see your medical provider

If you have hepatitis A, please cooperate with your local public health to help protect others

Vaccination Information

Hepatitis A can be prevented with a safe and effective vaccine. Stop the spread of this infection.

Who Should Get the HAV Vaccine?

Persons who are homeless.

Persons who are incarcerated.

Persons who use injection and non-injection illegal drugs.

Persons who work with the high risk populations listed above.

Persons who have close contact, care for, or live with someone who has HAV.

Persons who have sexual activities with someone who has HAV.

Men who have sex with men.

Travelers to countries with high or medium rates of HAV.

Persons with chronic liver disease, such as cirrhosis, hepatitis B, or hepatitis C.*

Persons with clotting factor disorders.

*Note: individuals with chronic liver disease (e.g., cirrhosis and hepatitis C) may not be at increased risk of getting HAV infections but are at increased risk of having poor outcomes if they are infected with HAV.

For information on where to get vaccinated:

If you (or someone you know) do not have health insurance, you will likely qualify for free or low cost vaccines. Talk with your local health department to find out if you qualify. For additional information, contact the MDHHS Division of Immunization at 517-335-8159.