1. Opinion

Column: Prevention, Protection key to fighting hepatitis A

DIRK SHADD   |   Times   Dr. Ulyee Choe, director of the Florida Department of Health in Pinellas County.
DIRK SHADD | Times Dr. Ulyee Choe, director of the Florida Department of Health in Pinellas County.
Published Mar. 15, 2019

Special to the Times

We are seeing a record number of hepatitis A cases in Pinellas County, the state, and the nation. Last year, Pinellas had 113 cases of hepatitis A and in 2019, we have had 121 cases so far. What is concerning is that in the previous five years, we only had an average of two to four cases annually.

Infectious diseases are not new to any community. We have faced several outbreaks in the past such as measles and locally acquired Zika. With those outbreaks, we could stamp out the disease within a matter of weeks to months. The difference here is that it is linked to other issues such as substance abuse and homelessness. And if the disease course mirrors the trends seen in other states with hepatitis A, we may continue to see increased cases for the next few years.

What is hepatitis A? It is a highly contagious, vaccine-preventable disease that causes inflammation of the liver. The disease spreads through contact with the infected feces of a person with the disease. The infection may be spread by eating or drinking contaminated items or from close contact with a person or object that is infected. Symptoms typically do not appear until an individual has been infected for a few weeks. Some common signs and symptoms of hepatitis A include fatigue, nausea, vomiting, abdominal pain, loss of appetite, low-grade fever, yellowing the skin and the whites of the eyes, clay-colored stool and dark urine. While most people will make a full recovery, individuals can develop liver failure and die.

Who is at risk? The highest risk groups include drug use, recent incarceration, and homelessness. Other risk factors include men who have sex with men and having hepatitis B or C co-infection. None of the individuals were vaccinated against hepatitis A. In many ways, the hepatitis A cases are mirroring the rise of the use of illicit substances. More than 50 percent of cases were drug users. In 2018, we saw both the largest number of hepatitis A cases and drug overdose deaths in Pinellas County. However, given the increased numbers in our community, anyone who is not vaccinated is potentially at risk.

The Florida Department of Health in Pinellas has taken multiple steps in protecting the community by offering the two-dose hepatitis A vaccine at no cost. Studies have shown that even one shot of the hepatitis A vaccine is 95 percent effective. As a result, we have provided more than 3,600 vaccines at the health department since January 2018. We have implemented various awareness. We have also engaged multiple community partners, including the jail, substance abuse providers, and homeless shelters, and conducted dozens of outreach activities. Department of Health epidemiology teams will continue to investigate all new cases and make appropriate notifications when there is a risk to the public. Private medical providers have provided more than 35,000 vaccines. We need to remain vigilant and continue all these efforts.

Our message continues to be one of prevention and protection. The best way to prevent hepatitis A is by receiving the hepatitis A vaccine. The vaccine has been proven to be safe and very effective. Everybody needs the vaccine given the increase in cases. Protect yourself and others by practicing good hand hygiene. Wash your hands after using the bathroom, changing diapers, and before preparing or eating food.

In the end, hepatitis A is containable and most importantly, preventable, but everyone needs to do their part. Remember to always practice good hand hygiene and get your hepatitis A vaccine today.

Dr. Ulyee Choe is the director of the Florida Department of Health in Pinellas County. He is an infectious disease specialist and an associate professor at the University of South Florida Morsani College of Medicine.