The Michigan Department of Health and Human Services (MDHHS) and local public health officials are continuing to investigate an outbreak of hepatitis A cases in the city of Detroit, and Macomb, Oakland, Wayne, and St. Clair counties. From August 1, 2016 to June 26, 2017, there have been nearly 190 cases of confirmed hepatitis A including ten deaths reported to public health authorities in these jurisdictions. This represents a ten-fold increase during the same time last year.
Ages of the cases range from 21 to 86 years, with an average age of 44 years. Two-thirds of the cases (66 percent) are men, and nearly nine out of ten (87 percent) have been hospitalized. While no common source of the outbreak such as contaminated food or water has been identified, transmission does appear to be person-to-person through illicit drug use, sexual activity, and close contact among household members.
The ongoing hepatitis A outbreak presents a significant public health threat to vulnerable community members within Southeast Michigan. Nearly half of the cases (47 percent) have a history of substance abuse, 20 percent are co-infected with hepatitis C, and six more recent cases have been incarcerated.
“Hepatitis A is a vaccine-preventable disease,” said Dr. Eden Wells, chief medical executive for MDHHS. “And while the hepatitis A vaccine is recommended as part of the routine childhood vaccination schedule, most adults have not been vaccinated against the hepatitis A virus and may be susceptible to the illness.”
To end the outbreak in SE Michigan, the vaccination is being recommended for the following at–risk individuals:
- People who use injection and non-injection illegal drugs
- People who participate in commercial exchange of sexual practices
- Close personal contacts (e.g., household, sexual) of hepatitis A patients
- Men who have sex with men
- People with liver diseases, such as hepatitis B or hepatitis C. Persons with chronic liver disease have an elevated risk of death from liver failure
- Any person who wishes to be immune to hepatitis A
- People who live, work, or recreate in SE Michigan and are concerned about getting hepatitis A
Individuals with hepatitis A are infectious for two weeks prior to symptom onset. Symptoms of hepatitis A include jaundice (yellowing of the skin), fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, and light-colored stools. Symptoms usually appear over a number of days and last less than two months; however, some people can be ill for as long as six months. Hepatitis A can sometimes cause liver failure and death.
Risk factors for a hepatitis A infection include living with someone who has hepatitis A, having sexual contact with someone who has hepatitis A, or sharing injection or non-injection illegal drugs with someone who has hepatitis A. The hepatitis A virus can also be transmitted through contaminated food or water.
Together with local health departments, MDHHS urges those individuals at greatest risk to seek hepatitis A vaccination at the locations below. Residents in the city of Detroit and Macomb, Oakland, St. Clair, and Wayne counties should talk to their healthcare provider about their risks for hepatitis A.
Please contact your local health department for more information about how to receive the hepatitis A vaccine:
- Washtenaw County Health Department, 734-544-6700
- Macomb County Health Department, 586-469-5372
- Oakland County Health Division, 1-800-848-5533 or email firstname.lastname@example.org
- Clair County Health Department, 810-987-5300
- Wayne County Communicable Disease Unit, 734-727-7078
- Detroit Health Department, 313-876-4000