Hepatitis A has spread to Upshur County. Now what?

BUCKHANNON – The bad news first: one case of the infectious liver disease Hepatitis A has been confirmed in Upshur County.

An outbreak of the disease continues to spread north after infecting thousands of people in southern West Virginia and Kentucky, with a handful of cases now reported in Braxton, Webster, Randolph, Harrison and Monongalia counties.

Although Upshur County is now on that list, the good news is that the lone case isn’t restaurant-related, Upshur-Buckhannon Health Department nurse director Sue McKisic said Tuesday.

In addition, McKisic said the health department has plenty of the vaccine on hand to help prevent further spread of the disease.

She explained the health department learned about the single case of Hepatitis A a couple weeks ago after officials there were contacted by a local medical provider.

Doctors, nurses, lab technicians and other medical providers who become aware that person has tested positive for an infectious disease like Hepatitis A are required by law to report it to the state. They must also report it to the county health department in which that person resides.

That’s what happened in this instance.

“We received a report that we had a positive Hepatitis A case, and it’s our responsibility to investigate it,” McKisic said.

That involves interviewing the patient, gathering additional background information and submitting a report to the W.Va. Department of Health and Human Resources’ Office of Prevention and Epidemiology Services.

So, what exactly is Hepatitis A and how does it spread?

Not everyone who contracts the liver disease has symptoms; however, those who do typically develop them suddenly about two weeks after exposure to the virus.

Symptoms may include the quick onset of fever, fatigue, appetite loss, nausea or other abdominal discomfort, dark urine and jaundice or yellowing of the skin and eyes, according to information from the national Immunization Action Coalition.

Hepatitis A is spread through a “fecal-oral route,” McKisic said. Typically, that means through the consumption of contaminated food, beverages or ice, but it can also spread through poor hygiene.

“With the outbreak in the southern part of the state, the first people that were targeted [for prevention of further spread of the disease] were homeless people or homeless and IV drug use population,” McKisic said. “That’s because we know homeless people can’t always take showers, can’t always have the best hygiene. They are really encouraging hand hygiene.

“These homeless people use the bathroom, they don’t have facilities, they don’t have a way to wash their hands, so then they are going for a long time without good hygiene habits, and they can end up with it.”

Hepatitis A tends to be acute rather than chronic, McKisic explained.

“Sometimes, people’s bodies just shed it and they don’t even know they have it, but then with this outbreak (in southern West Virginia counties), they’ve been putting patients in the hospital and giving them IV antibiotics and there have been some deaths from it,” she said.

As of Friday, five deaths in West Virginia were attributed to Hepatitis A, statistics collected by the DHHR indicate.

Although the single case in Upshur County isn’t restaurant-related, in other counties where disease is currently most prevalent – Kanawha and Cabell top the list – the spread of Hepatitis A has been connected to eating establishments.

“In the southern part of the state, there have been some cases that are restaurant-related because these people have Hep A and they work in a restaurant,” McKisic said, “and just because [a person] is homeless doesn’t mean they don’t want to go to work so they can have money to buy food, or in some cases, buy drugs.”

The health department says it’s prepared to handle the threat of an outbreak.

McKisic said the state has given the department an allotted amount of the Hepatitis A vaccine to administer at no cost to members of the at-risk population – i.e. homeless people and people addicted to substances.

However, the vaccine is available to anyone in the county who wants it; it’s just not free to people who aren’t classified as “at-risk.”

In those cases, the health department accepts health insurance to cover the cost, and McKisic said most insurance companies pay for the Hepatitis A vaccine.

The health department orders dosages in batches – specifically, enough doses to cover 40 adults and 40 children at a time, she said.

On Tuesday evening, board of health chairman Michael Livesay said residents should rest assured there’s plenty of the vaccine on hand, should they choose to receive it.

“We are taking the necessary precautions and being proactive in regards to this issue to protect our county,” Livesay told My Buckhannon. “We have the Hepatitis A vaccine in stock and on site in the Health Department for residents to receive if they want it.

“I have asked our Nurse Director Sue McKisic to order additional Hepatitis A vaccine so that we are prepared for the additional demand if need be.”

McKisic said although there’s typically 10 or fewer cases in the Mountain State annually, according to data available through the DHHR, as of Friday, there were 1,466 cases in West Virginia. The counties with the most cases are Kanawha (689), Cabell (236) and Putnam (96).

The data also shows that Randolph, Upshur and Braxton counties have less than five cases, while none have been discovered in Lewis County; seven were found in Webster County. Just over 750 hospitalizations have resulted from the outbreak and nearly 60 percent of patients are male.

McKisic said even though there’s not an outbreak in Upshur County now – there must be at least two linked cases to constitute an outbreak – the county isn’t insulated from the disease and the virus that causes it.

“There are plenty of people who drive down to Charleston on a regular basis,” she said. “We don’t want to get into the mindset that ‘this can’t happen here.’”

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