In November 2017, the Kentucky Department for Public Health (DPH) identified an outbreak of acute hepatitis A. The increase in cases observed in Kentucky was well over the 10-year average of reported hepatitis A cases. Several cases have been infected with HAV strains genetically linked to outbreaks in California, Utah and Michigan. Similar to hepatitis A outbreaks in other states, the primary risk factors remain illicit drug use and homelessness. A contaminated food source has not been identified and transmission is believed to be occurring through person-to-person contact.
Information for Healthcare Providers
Healthcare providers should prioritize the identification and reporting of cases of acute hepatitis A in their at-risk patients. If acute hepatitis A is suspected, contact local or state public health within 24 hours, in accordance with
902 KAR 2:020. Specimens for molecular testing should also be considered. Clinical advisories and laboratory guidance are available below. Vaccination of at-risk individuals remains the best means of control. Please consider hepatitis A vaccination in accordance with ACIP recommendations. CDC recommendations for outbreaks of hepatitis A are also available.
Information for Correctional and Substance Abuse Treatment Facilities
Congregate settings such as correctional facilities and substance abuse treatment facilities are at higher risk for transmission of hepatitis A if a case is identified in the facility. Occupants of these facilities should be evaluated for signs and symptoms of hepatitis A upon admission and educated about hepatitis A. Staff should closely monitor these populations for symptoms of acute hepatitis A and encourage staff to report any signs or symptoms of the disease should they occur. If the disease is suspected, the person should be isolated in an effort to prevent further spread of the disease and should see a physician as soon as possible. In addition, these persons should not participate in food preparation until cleared by public health. If acute hepatitis A is suspected, contact local or state public health within 24 hours, in accordance with 902 KAR 2:020.
Facilities that provide services to at-risk populations should implement disinfection procedures that are effective against hepatitis A. DPH recommends that facilities review disinfection procedures to ensure products being used are both effective against hepatitis A virus and are being used in accordance with the manufacturer's label. Guidance and additional materials are available in the Hepatitis A Environmental Health Toolkit.