Hepatitis-A Outbreak In South Florida Not A Local Threat

Apr 30, 2019

Credit Florida DOH

First, the good news.

"Here in Escambia (County) we have had only one case (of Hepatitis-A), and that was in a person who came to our area from a different country," said Dr. John Lanza, director of the Florida Department of Health in Escambia County.

He says a few of our neighboring counties have not been as lucky. "Santa Rosa (County) has had several cases, Okaloosa has had some cases over the past few months. (That's) higher than is typically seen."

The reason Hepatitis-A is starting to get attention in Florida is because of an outbreak of the disease in Martin County, on the Atlantic coast just north of Palm Beach County. As of mid-April there are have been 19 confirmed cases of Hepatitis-A in Martin County.

Even more surprising than that number is that there have been three confirmed deaths from complications of the disease.

"That is surprising because typically the vast majority of people who are infected with Hepatitis-A recover completely without any problem or sequela from the disease," said Dr. Wayne Adkisson, a gastroenterologist at Sacred Heart Hospital in Pensacola. "People that would tend to have complications from Hepatitis-A would be those that would be immuno-compromised people, elderly people, people with underlying chronic liver conditions or diseases."

So just how rare are deaths from Hepatitis-A? According to the CDC, 140 people have died in the U.S. as a result of complications from the disease since 2016, that’s out of a total of about 15,000 cases.

Unlike Hepatitis B and C, Hep-A is not a chronic disease. You get it — and there’s no pleasant way to say this — by ingesting fecal matter passed on from another person. There’s a reason they have those signs in rest rooms that say employees must wash their hands. Dr. Adkisson says that once you are infected with the virus, it will be a few weeks before you start to feel sick.

"It incubates in your body for about 28 to 30 days, about a month. And then you begin to have symptoms (like) nausea, vomiting, some vague abdominal pain, maybe right upper quadrant pain, that's where the liver is located. Then you'll begin to turn jaundiced. So the whites of your eyes will turn yellow, your skin turns yellow, and (those are) the clinical signs and symptoms and manifestations of acute infection. that typically will pass within a couple of weeks. And then we check blood work, usually several months after those symptoms have abated, to determine that you've cleared the virus. And once your body's immune system has cleared the virus, which happens in well over 95 percent of cases in the United States, then you have lifelong immunity."

That’s right. Once you get Hepatitis-A you can never get it again. There is a vaccine for the disease and since 2006 it has become part of the childhood vaccine schedule. The vaccine is also available for adults. Dr. Lanza from Escambia County says they are taking steps to make sure there is not a spike in local cases.

"We are a low risk county currently and what we've been doing for the past several months is making contacts with our partners (like) the county jail, Community Health Northwest Florida, The Lakeview Center, Opening Doors Northwest Florida to look at setting up Hepatitis-A vaccination clinics," he said. "Now what we're typically seeing is outbreaks in specific populations such as drug users, either intravenous or non-intravenous, MSMs which is males having sex with males, and to a lower extent in the homeless population. And this is (all) across the state."

And Dr. Lanza says the vaccine is available to anyone who thinks they may be at high risk of contracting the virus just by visiting an Escambia County Department of Health office.