BLUEFIELD — West Virginia has seen 1,859 cases of Hepatitis A associated with a multi-state outbreak that began last year, prompting concern and a move to vaccinate first-responders.
A case in Raleigh County has garnered attention because it involved a food service worker at Ghent Elementary School who recently tested positive for the highly contagious virus, according to an article in the Beckley Register-Herald.
The Raleigh County School Board issued a statement saying school officials are working with the Beckley-Raleigh County Health Department to prevent any new cases.
No other cases related to the worker at the school have been reported, the article said.
But several area counties, including Mercer County, have reported cases so far this year.
According to the West Virginia Department of Health and Human Resources (DHHR), the number of cases of Hepatitis A, which is an infection in the liver, reported during the outbreak stands at six in Mercer County, with less than five in Monroe and McDowell counties.
Tazewell County, as part of a four-county area in Southwest Virginia, has seen two cases, which do not appear to be part of the outbreak.
The West Virginia increase in cases has primarily been among injection and non-injection drug users, homeless or mobile individuals, and those who have been recently incarcerated. Viral sequencing has linked cases from Kentucky and California, the DHHR report said.
Those infected ranged in age from 12 to 86, DHHR said, with the median age at 37 and 1,119 male, 960 hospitalizations and five deaths.
Of those cases, 852 were co-infected with Hepatitis C, 158 with Hepatitis B. Illicit drug use was reported in 1,178 cases and 202 of those infected were homeless.
Julie Mundell, Registered Nurse and public health nurse with the Monroe County Health Department in Union, said the county has seen “less than five” cases since the outbreak in the state was first reported earlier this year.
When a case is confirmed, Mundell said an attempt is made to contain it.
“We try to identify anybody who may have had contact,” she said. “We do an assessment of what their risks were.”
That may be followed by a vaccination, if they choose to do it, and monitoring any sign of symptoms.
Mundell said the vaccination is safe and effective.
“We have been working very hard getting all of our first-responders immunized,” she said, adding that they are more vulnerable to be exposed to the virus.
Tim Farley, public safety director for Mercer County, said he is well aware of the problem and is also working to make sure first-responders receive the vaccination.
“It’s mandatory for EMS crews, the rescue squads in Bluefield and Princeton,” he said. “I think the fire department personnel have been vaccinated as well.”
Farley said some volunteers have also received the vaccine, but not all of them.
“It’s always been a big concern,” he said.
According to the Center for Disease Control (CDC) in Atlanta, the virus can survive outside a body for months and be transmitted by ingesting the virus from objects, food, or drinks contaminated by small, undetected amounts of stool from an infected person.
Hepatitis A can also spread from close personal contact with an infected person such as through sex or caring for someone who is ill.
The “shelf life” of the virus outside the body is a concern.
“I think this is one of the challenges in being able to control this ongoing outbreak in other states,” said Page Lucas, epidemiologist with the Tazewell County Health Department and the Cumberland Plateau Health District. “It’s a very contagious organism.”
Lucas said the health district, which serves four counties in Southwest Virginia, has seen two cases of Hepatitis A this year.
“We have had two cases so far, but that’s about average,” she said. “We have not seen any more than we usually do.”
Lucas said rates have gone up in Tennessee, Kentucky and West Virginia, though.
“So far, we don’t seem to be affected (with an increase),” she said.
Cathy Catron, a Registered Nurse and public health nurse who also works for the Cumberland Plateau Health District, said immunizations for Hepatitis A are “readily available” for both adults and children.
All children can be immunized for the virus at 12 months old, she said, adding that it takes two shots, at least six months apart.
Although the immunization is not required to attend public schools, it is recommended, she said, and if an adult or child is not insured, the shots are free.
“Everyone can receive the vaccine,” she said.
Both Lucas and Catron agree that the best and easiest preventive measure is hand-washing.
“That is the best thing we can do to prevent about anything,” Catron said, “from the flu to a cold, almost any kind of disease.”
Mundell also said washing hands is crucial and she also recommends children receive the vaccination because it is not required in West Virginia schools either.
“We do try to recommend that (to parents),” she said.
According to the CDC, symptoms of Hepatitis A include fever, fatigue, loss of appetite, nausea, abdominal paid, dark urine, diarrhea and joint pain.
If symptoms occur, they usually start appearing 4 weeks after exposure, but can occur as early as 2 and as late as 7 weeks after exposure. Symptoms usually develop over a period of several days.
The sickness can range from a mild illness lasting a few weeks to a severe illness lasting several months, the CDC says, and, although rare, hepatitis A can cause death in some people.
— Contact Charles Boothe at cboothe@bdtonline.com
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