2 dead with 233 sick with Hepatitis A.

The Salt Lake County Health Department (SLCoHD) announced today that two county residents have died due to Utah’s ongoing hepatitis A outbreak. The first death occurred in January but due to other health conditions affecting the individual, officials were waiting on confirmatory tests to declare an official cause of death. The second death occurred in late March.

Both deceased individuals were adults who belonged to one or more population groups previously identified by health officials as high-risk for contracting hepatitis A in this outbreak (people experiencing homelessness, people who use illicit drugs, or people who are or have recently been incarcerated). Due to medical privacy laws, public health officials are unable to share additional specifics about these individuals.

“These deaths are a tragic reminder that hepatitis A is a serious disease—but one that is preventable,” said Dr. Dagmar Vitek, medical director for SLCoHD. “Vaccination is the best way to prevent infection, and the vaccine is widely available from health care providers, pharmacies, and Salt Lake County immunization clinics.”

Hepatitis A vaccine is given via two shots at least six months apart. The U.S. Centers for Disease Control and Prevention reports that the first dose provides 94% protection against hepatitis A for 2–5 years and the second dose provides 99% protection for 20–25 years. Vaccine appointments are available at Salt Lake County immunization clinics by calling 385-468-SHOT.

People can also dramatically reduce their risk of contracting hepatitis A by washing their hands frequently and thoroughly, especially after using the restroom, changing diapers, and eating, serving or preparing food.

“Food handlers must be especially vigilant about hand washing, and we encourage restaurant workers to consider receiving the vaccine to protect both themselves and their customers,” continued Dr. Vitek.

Through April 2, Salt Lake County has identified 148 cases of hepatitis A related to this outbreak (Utah has seen 212 cases to date). Epidemiologists have linked the Utah outbreak, which began in the summer of 2017, to a national outbreak first reported in San Diego, California.

Since January 1, 2017, Utah public health has identified 233 confirmed cases of hepatitis A virus (HAV) infection; many among persons who are homeless and/or using illicit drugs. Several cases have been linked by investigation and/or viral sequencing to a national outbreak of hepatitis A involving cases in California and Arizona. Hospitalization rates of less than 40% have been described in previous hepatitis A outbreaks; however, other jurisdictions associated with this outbreak are reporting case hospitalization rates approaching 70%. The high rate of hospitalization may be a result of cases having underlying illnesses (e.g., alcoholism), or a higher rate of hepatitis comorbidities (e.g., hepatitis B or C). In response to the outbreak, public health officials have been working to identify cases and contacts, provide education, and ensure opportunities for vaccination of close contacts to cases and vulnerable populations.

Since August 2017, SLCoHD has conducted targeted vaccination and awareness campaigns to try to control the outbreak, including holding on-site vaccination clinics at community locations where individuals thought to be at high risk congregate. The department has also distributed thousands of hygiene kits to people in need; the kits contain soap, disinfectant wipes, and other products encouraging hand washing and good hygiene.

Hepatitis A is a contagious liver disease that (unlike other forms of hepatitis) does not usually result in chronic infection. It is caused by a virus and can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months. Hepatitis A is usually spread when a person ingests the virus from contact with objects, food, or drinks contaminated by feces from an infected person. Symptoms of infection include fatigue, nausea, abdominal pain, diarrhea, and jaundice (yellowing of the skin and eyes).