Amid hepatitis A outbreak, state 'most concerned' about Wayne County

WAYNE COUNTY, Ind. – Local cases of hepatitis A have nearly doubled in the last two weeks, as county and state officials continue searching for ways to limit spread of the disease.

The Indiana State Dept. of Health released new numbers Friday morning showing reported incidents of the virus in Wayne County had risen to 45 total, up from 31 last week and 23 the week prior.

The county is No. 3 in the state for number of hepatitis A cases since the year began and is on pace to become the state's most infected county by the end of the month.

County health officials have continued to encourage vaccinations for those at risk of exposure to hepatitis A in recent weeks, and have provided more than 800 shots to area residents since mid-July.

►RELATED: Wayne County among hardest-hit by hepatitis A. But why?

This week, Indiana State Health Commissioner Kristina Box said she continued to have concerns over the prevalence of the liver-affecting disease in eastern Indiana, and said the ISDH remains committed to fighting the outbreak.

Box stopped short of saying the issue constituted an epidemic for the area — the disease has infected about .06-percent of the county's 70,000 residents — but did say Wayne County remains one of the state's top priorities in stopping the ongoing crisis.

"We certainly have an outbreak, and Wayne County is one of the counties we're most concerned about," she said.

It's hard to say exactly how the disease has spread in the county, and around the state, because the ISDH does not identify the origin or cause of any incidents unless there is a public health concern over its continued transmission from a certain source.

For example, the state made the public aware of an incident of exposure at Centerville's Casey's General Store in July, in order for those who may have bought food prepared at the establishment to get themselves vaccinated.

Generally though, little or nothing is said when there is a new case reported.

Growing numbers

As it stands, Wayne County is unlike most of the other counties currently facing problems with hepatitis A; its numbers continue to grow substantially with each passing week while the trend has begun to slow, if not completely stall, in other hard-hit parts of the state.

The county has seen 14 newly reported cases in the past week, and 21 since July 20.

In Clark County, which still remains the state's leader with 68 reported incidents of hepatitis A this year, few additional cases have been discovered in recent weeks; the county's number is up by only three since the mid-July report.

►RELATED: Indiana sees first death from hepatitis A

The same can be said in Lawrence and Floyd counties, which saw increases of three and one, respectively, in the same time period.

Wayne County surpassed Floyd as the state's third overall due to the continued climb in the number of cases reported locally.

About 334 people have been infected with hepatitis A in Indiana, including one person who died from the disease. In most years, Indiana generally doesn't surpass 20 cases of hepatitis A.

Nationally, more than 4,500 cases of hepatitis A have been reported during the outbreak, leading to at least 61 deaths across 10 states.

What's next?

Box said the state will continue working with the Wayne County Health Dept. as they look to find a solution to the ongoing problem.

She lauded the agency's effort to make the public aware of the crisis, as well as its work in distributing vaccines to more than 800 people in recent weeks.

"The local health department ... is doing an amazing job of getting out and getting everybody vaccinated," she said. "They have really done a remarkable job."

She said she encourages anyone at risk of infection to receive a vaccination. This includes, according to the Centers for Disease Control and Prevention:

• All children, at 1 year old
• Travelers visiting countries with high-rates of hepatitis A
• Family members and caregivers of recent adoptees from countries where the infection is common
• Men who have sexual contact with other men
• People who use injection and non-injection illegal drugs
• People with chronic (lifelong) liver diseases, such as hepatitis B or hepatitis C
• People who are treated with clotting-factor concentrates
• People who work with hepatitis A infected animals or in a hepatitis A research laboratory

Box said while hepatitis A is generally not spread through blood contamination, but rather through residual fecal matter, illicit drug users at often at high risk of infection. She said this is especially true in instances of needle sharing.

"Just the lack of hygiene; that fecal-oral contamination, that contamination that's on your hands after you go to the bathroom and maybe don't cleanse as well, and then use a needle," she said. "That can allow you to get infected with (hepatitis A)."

As part of its efforts to increase the availability of inoculations locally and around Indiana, Box said the state health department has purchased thousands of vials of vaccines, including some produced by private companies, "at a reduced cost."

During a clinic in mid-July, the county health department distributed more than 500 vaccines, and later conducted a clinic at the Wayne County Jail for inmates to be inoculated.

The state has received millions of dollars in federal funding to fight the outbreak, as have nine other states currently facing what the Centers for Disease Control and Prevention consider hepatitis A hotbeds.

The state is also expected to cover the cost of a booster shot associated with the vaccine — recommended about six months after the initial shot is received —  for those who do not have insurance that will cover the shot for them, Box said.

Those individuals with insurance, she said, should be able to receive the booster without issue from local pharmacies or their primary care physician.

Throughout Indiana, more than 52,500 shots have been administered so far this year.

"The entire state will be able to vaccinated if they desire," she said. "But we're making sure that those (vaccines) are available first to our highest-risk counties."

Mickey Shuey is the business reporter at the Palladium-Item. Contact him at (765) 973-4472 or mshuey@gannett.com. You can also follow him on Twitter: @MickeyShuey, or on Facebook: www.facebook.com/MickeyShuey.