Outbreak: More than 100 cases of hepatitis A confirmed in Jefferson County

An outbreak of hepatitis A has been confirmed in Jefferson County.

Health officials noted 115 cases from November through Friday, said Dave Langdon, spokesman for the Louisville Metro Department of Public Health and Wellness. One of those cases is an employee at a Kroger store at 4915 Dixie Highway, which prompted the grocery chain to issue an alert Friday to shoppers who bought produce there from Feb. 4-28.

There are typically four or fewer cases in an entire year, Langdon said. "We don't know the exact cause."

Hepatitis A is a disease of the liver caused by a virus. It tends to hit adults hardest, with symptoms including yellowing of the skin and whites of the eyes; fever and body aches; stomach pain, nausea and vomiting; and darker urine and lighter-colored stools, said Dr. Lori Caloia, the health department's medical director.

Symptoms usually last less than two months, but between 10 percent and 15 percent of victims remain sick for up to six months, according to the Centers for Disease Control and Prevention's website.

"It is usually transmitted person-to-person through the fecal-oral route or consumption of contaminated food or water," according to the CDC's website.

Caloia said Kroger acted quickly, contacting customers who bought produce during the dates of possible contamination.

Kroger spokesman Tim McGurk said the company sent a recorded message to thousands using phone numbers associated with their Kroger Plus cards. And, knowing some customers might not have kept their their phone number updated, a message will be printed on their receipt the next time they shop using their loyalty program cards.

The Kroger associate had followed safety procedures, wearing gloves while handling produce before knowing he contracted the disease, McGurk said.

This greatly reduced — but didn't totally eliminate — the risks of contaminating others, the doctor said.

Symptoms usually don't show up until four weeks after exposure, but they can take seven weeks to surface, according to the CDC.

The Kroger employee has not returned to work while he is being treated, McGurk said.

Epidemiologists with the CDC, based in Atlanta, came to Louisville recently to meet with Caloia and state health officials. The agency also provided thousands of vaccines for distribution to the poor and to the highest-risk populations — drug users and the homeless or transient.

More about this: Here's what we know about the Kroger hepatitis A case

More than 5,700 people, mostly those considered at highest risk, have been vaccinated across the city since the outbreak began, Langdon said. Health officials took shots to homeless camps, shelters and centers that offer services. They also offered the vaccine to drug users gathered at needle exchange sites.

Starting in August, all students in Jefferson County Public Schools must get two doses of the vaccine to attend school.

Background: Kroger worker with hepatitis A may have exposed shoppers to the virus at a Louisville store

Some local inmates have tested positive for hepatitis A, prompting a series of immunizations at the jail for staff and inmates. Steve Durham, assistant director of Louisville Metro Department of Corrections, said it's not an outbreak due to the jail's ongoing cooperation with health officials.

There have been small outbreaks in other areas of the commonwealth.

"The vast majority of the cases have been in Jefferson County," Langdon said.

He said that's because Louisville is the biggest city and has the largest number of homeless, an at-risk population, in Kentucky.

There have been similar hepatitis A outbreaks in San Diego and parts of Utah, Michigan and Colorado, the doctor said.

Langdon said the CDC reviewed Louisville's plan of action, lauding it as a possible model for other cities facing the same outbreak.

For more information about the disease, go to www.cdc.gov and search for hepatitis A.

Reporter Beth Warren: bwarren@courier-journal.com; 502-582-7164; Twitter @BethWarrenCJ. Support strong local journalism by subscribing today: www.courier-journal.com/bethw.