By Greg Bird
McCreary County had recorded five cases of Hepatitis A in November according to a news release from the Lake Cumberland Area Health District. An additional case was confirmed earlier this week, bringing the total number of cases to six.
The six cases in November is equivalent to 3.3 cases per every 10,000 people, more than three times the statewide average of 1.02 cases per 10,000.
The Center for Disease Control defines an outbreak as: “The occurrence of more cases of disease than expected in a given area or among a specific group of people over a particular period of time.”
So McCreary County’s recent reported cases does qualify as an outbreak, and health officials are encouraging everyone to get vaccinated against the preventable disease and to practice regular hand washing – especially before making food and after using the bathroom.
Hepatitis A spreads when a person ingests fecal matter, even tiny amounts, from contaminated food or drink. The liver is the most affected. Health authorities say the people most likely to be infected with hepatitis A are needle-drug users, the homeless, and some men who have sex with men.
“We are experiencing a nation wide outbreak, with Kentucky currently seeing the worst outbreak in the nation,” said Shawn Crabtree, Executive Director for the Lake Cumberland Area Health District. “Since August of last year there were 2,769 cases reported, with 1,438 requiring hospitalization and 17 deaths.”
As the majority of the reported cases involve drug users and homeless, it may be difficult to contain the disease in the short term, and the disease may continue to spread.
“Five cases in McCreary County in one month is very significant,” he said. “My guess is we’re not at the end of it. That population is difficult for public health to find, as they tend to not want to be found.”
Crabtree said the health district has not identified any contaminated food sources, such as restaurants in the outbreak and believe the disease spread locally through person-to-person contact. Transmission of the virus occurs via oral contact with contaminated hands or objects.
If there were a local restaurant associated with the outbreak the Health District would notify the public and take steps to address the issue at the source. Monday afternoon the regional health district identified a Pulaski County eatery, Zaxby’s, as a potential contamination source with an employee diagnosed with Hepatitis A.
The district said there is minimal risk of contracting hepatitis A from this establishment or any other food establishment at this time, and no case of hepatitis A in the current McCreary outbreak has been associated with food service establishments.
While the major outbreak this year has occurred in northern Kentucky, the Lake Cumberland Health District has recorded several new cases in their 10-county district over the past several months.
Since June Taylor County had recorded 40 new Hepatitis A cases, with a peak of 15 in August. There were still 2 new cases recorded last month in Taylor County, and Crabtree believes the outbreak may be on the way out in that area.
Other counties reporting new cases last month include four in Pulaski, and one in Russell County. Statewide there were 455 new cases reported, with the majority of the instances occurring in the northern part of the state.
Hepatitis A is a viral infection of the liver that can cause loss of appetite, nausea, tiredness, fever, stomach pain, yellowing of skin and eyes, brown-colored urine and light-colored stools. People may have some or none of these symptoms and it could take up to seven weeks after being exposed to the virus for someone to become ill.
The hepatitis A vaccine is given in two doses, six months apart. The first shot provides short-term protection and the second shot provides long-term protection. The vaccine is available at most doctors’ offices, pharmacies and retail clinics and the local Health Department.