PUBLIC HEALTH
HEPATITIS A Outbreak Update
Lori Caloia, MD
J
ust over a year ago, on November 21,
2017, the state of Kentucky declared
an outbreak of acute hepatitis A. The
outbreak challenged community and
health department resources in our
attempt to reach the highest-risk individuals,
including the homeless and those who use
illicit drugs. US. Kentucky has outpaced other states, and our outbreak reached
3,265 hepatitis A cases with 1,625 hospitalizations and 21 deaths
as of December 15, 2018.
We struggled to get hepatitis A under control locally, and, with
the input of the medical community and many other local partner-
ships, we have successfully reduced the rates of hepatitis A virus
infections in Jefferson County. In fact, our response was recognized
by the Centers for Disease Control and Prevention (CDC) as an
example to follow for other jurisdictions. Although we have not seen the very high rates of hepatitis A in
our homeless populations that other cities have seen, due in large
part to our early vaccination efforts in partnership with the Coali-
tion for the Homeless in Jefferson County, this population remains
at risk. Any person with unstable housing who has not yet been
vaccinated should receive hepatitis A vaccine.
Though our numbers have declined in Jefferson County, the
Kentucky Department of Public Health and Louisville Metro De-
partment of Public Health and Wellness continue to recommend
vaccination of anyone who desires immunity - especially those in
high-risk populations.
New cases in Louisville have fallen from a high
of more than four per day in April 2018 to about
0.25 per day; December 2018.
Many of you have been on the front lines along
with Louisville Metro Department of Health and
Wellness diagnosing and treating individuals with
hepatitis A infection, reporting cases to our com-
municable diseases department, and championing
vaccination in the patients you serve. As a commu-
nity, we have given more than 100,000 hepatitis A
vaccines since the outbreak began! We are grateful
to you all, and we know that our response would
not have been nearly as effective without you. Thank
you!
Unfortunately, despite our local success, rates
of hepatitis A virus infection continue to climb
throughout the state and the region as new states
continue to be added to the outbreak list in the
(continued on page 9)
FEBRUARY 2019
7