Michigan health authorities are continuing their investigation of a hepatitis A outbreak that has steadily spread across southeastern Michigan to sicken more than 300 people over the past year.
The Michigan Department of Health and Human Services said the hepatitis A outbreak affects the city of Detroit as well as Macomb, Monroe, Oakland, Wayne, and St. Clair counties.
According to the Michigan health department, there have been 319 cases of confirmed hepatitis A between Aug. 1, 2016, and Sept. 15, 2017. Fourteen of those patients died from the illness. Nearly 86 percent of all the patients with confirmed cases have been hospitalized, the health department said.
Ages of the infected patients range from 20 to 87 years, with a median age of 42.5 years, and two-thirds of the cases (64 percent) are men. While no common source of the outbreak, such as contaminated food or water, has been identified, “transmission does appear to be person-to-person through illicit drug use, sexual activity, and close contact among household members,” the state health department said.
Individuals with hepatitis A are infectious for two weeks prior to the onset of symptoms, which include jaundice (yellowing of the skin), fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, and dark urine. Symptoms usually appear over a number of days and last less than two months. Some people, however, can remain sick for as long as six months. Young children, the elderly, and anyone with frail or vulnerable immune systems is especially prone to develop liver toxicity, which can lead to liver failure and death.
“The ongoing hepatitis A outbreak presents a significant public health threat to vulnerable community members within Southeast Michigan,” the state health department said in an announcement. “Over half of the cases … have a history of substance abuse, 28 percent are co-infected with hepatitis C, 15 percent are homeless/in transient housing situations, and nineteen cases (6.4 percent) have a history of recent incarceration.”
Hepatitis A outbreaks are notoriously difficult to contain. The virus is extremely resilient, able to survive the body’s highly acidic digestive tract and can live outside the body for months, even in freezing temperatures. It is also highly contagious, and one infected person can infect many others.
San Diego is also grappling a major outbreak of hepatitis A that health authorities there attribute to the city’s epidemic of homelessness and lack of public bathrooms in the downtown area. The outbreak there has sickened more than 400 people and killed at least 15.
Major hepatitis A outbreaks also occurred recently in Hawaii, where the virus was liked to raw imported scallops used by the Genki Sushi chain of restaurants and in Virginia, where health officials traced the virus to imported strawberries used by the Tropical Smoothie Café chain.