West Virginia is reporting an increase in hepatitis A virus (HAV) cases in some counties, namely Kanawha and Putnam. Several have been molecularly linked to the multi-state outbreak in which genotype 1B is the HAV strain of concern; other cases have been epidemiologically-linked to cases from Kentucky.
To date, 17 West Virginia cases have been hospitalized at four area hospitals. Cases are highly mobile, and many have been discharged against medical advice making it challenging for public health to follow-up with appropriate surveillance and prevention actions. Coinfections with hepatitis B (HBV) and hepatitis C (HCV) are prevalent. Methamphetamine and illicit drug use generally have been documented in many cases.
Because many states are experiencing large HAV outbreaks, increased demand for vaccine has resulted in restricted distribution. The West Virginia Bureau for Public Health (WVBPH) is working with the Centers for Disease Control and Prevention (CDC) to provide HAV vaccine to affected counties. Requests for vaccine must go through the Office of Epidemiology and Prevention Services, Division of Infectious Disease Epidemiology (DIDE). Vaccination campaigns should target contacts of HAV cases, homeless persons, and persons who use illicit drugs.
Healthcare providers who suspect HAV in patients are recommended to:
- Conduct a complete HAV, HBV, and HCV serology panel on symptomatic patients.
- Report suspected cases to the local health department immediately.
- Inform patients that someone from the local health department will contact them for follow-up.
- Offer HAV vaccine to persons who are homeless and/or use illicit drugs.
- Retain serum specimens for confirmatory testing and possible molecular testing at the CDC.
The WVBPH is seeking collaboration with various partners including substance use treatment facilities, homeless shelters, harm reduction programs, free clinics, and correctional facilities to disseminate information to high-risk populations. Information about HAV and the current outbreak can be found at: https://dhhr.wv.gov/oeps/disease/viral-hepatitis/pages/hepA_outbreak.aspx.
For additional information, you can contact DIDE at (304) 558-5358, extension 1; (800) 423-1271, extension 1; or the 24/7 answering service at (304) 925-9946.
Wheeling-Ohio County Health Department
1500 Chapline Street, Room 106
Wheeling, WV 26003
Howard Gamble, MPH
Becky Beckett, RN
Lock Johnson, RS
William Mercer, M.D.
Threat Preparedness Director
West Virginia is experiencing a Hepatitis A outbreak, which is linked to a multi-state outbreak. As of May 21, 2018 there has been 106 confirmed cases reported in 8 counties in West Virginia. This increase in confirmed cases of acute hepatitis A virus has been primarily among: IV and non-IV drug users Homeless or highly mobile individuals Recently incarcerated individuals In early May the Wheeling-Ohio County Health Department began vaccinating the homeless population through the d...Full Article