State’s hepatitis A outbreak is worst in nation, but seems to be fading in Louisville, which feds say is ‘gold standard’ for response

Kentucky’s hepatitis A outbreak is now the biggest outbreak in the United States. As of July 7, the outbreak had struck 65 of Kentucky’s 120 counties with 1,094 hepatitis A cases and eight deaths. But federal officials say Louisville is a national example for how to respond to an outbreak, reports Phillip M. Bailey of the Courier Journal.

As of July 17, Louisville had 540 cases and four deaths. While the liver disease continues to spread around the state, there is evidence that it may be declining. “It feels like we’re coming out of it,” Rui Zhao, epidemiologist for the Louisville Metro Department of Public Health and Wellness told Bailey.

“New reports of hep A infections reached as high as 4.1 cases per day in April,” Bailey reports. “Since then, that figure has plummeted to about 3.8 in May; 2.5 in June; and 1.67 in July.”

Officials of the U.S. Centers for Disease Control and Prevention came to Louisville July 21 to praise the health department’s work, WDRB-TV reports: “Louisville has set the gold standard for responding to the hepatitis A outbreak and set standard for the rest of the country,” CDC epidemiologist Doug Thoroughman said.

Since the outbreak was declared on November, the Louisville health department has vaccinated more than 78,000 people by focusing on homeless camps, health clinics and the jail. “It also has an aggressive campaign to shake the general public’s consciousness that they, too, can catch the disease,” Bailey reports. “About 10 percent of Louisville’s hep A diagnoses aren’t in those high-risk groups, according to health officials.”

State and local officials urge everyone in Kentucky that is part of the outbreak to get vaccinated. They also reminded everyone to practice good hand hygiene, particularly after using the restroom and before eating or preparing food.Health officials stressed the virus in the outbreak is being passed person-to-person. There has been no evidence that it is being spread by food or drink as was the case during the hepatitis A outbreak that struck Louisville in 1988. However, “Louisville restaurants have taken the lead by vaccinating their staff,” Bailey reports.

Boyd County and Ashland, its largest city, “recently passed measures requiring all food service workers to be vaccinated against the virus,” and adjoining Greenup County “is poised to join them,” reports Will Wright of the Lexington Herald Leader. “Boyd County has one of the highest infection rates of hepatitis A per-capita in the state, with 134 reported cases since August 2017.” Greenup has had 46 cases; Carter County, which adjoins them both, has had 85.

While the outbreak leads the nation, Dr. Jeffrey Howard, commissioner of the Kentucky Department for Public Health, said “Our surveillance and the fact that we’ve hospitalized about 60 percent of all cases has kept our death rate below that of other states experiencing hepatitis A outbreaks.”

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