Public health authorities in Tennessee say an outbreak of hepatitis A in the state has sickened at least 14 people in the Nashville area. The outbreak is one of a multitude of recent outbreaks ongoing nationwide, some of which have become unusually virile.
Although the number of confirmed hepatitis A cases in Tennessee seems small, officials say the Nashville outbreak is almost certainly larger than it seems because the virus can exist dormant and undetected in the body for several weeks. This allows the highly contagious virus to spread exponentially among a population while health authorities search for sources.
“However many cases there are right now, more people are infected already,” Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center told the Tennessean. “It can be a matter of three to four weeks before you get sick, so nobody knows you’re infected, but you can still transmit the virus.”
The first hepatitis A case in Nashville associated with this particular outbreak was confirmed in December, health officials say. Federal and state health officials are actively investigating the outbreak to determine its source.
According to the Tennessean, the U.S. Centers for Disease Control and Prevention (CDC) is looking into whether the virus may have spread to Nashville from another ongoing hepatitis A outbreak in Louisville, Kentucky, which was linked to an ongoing outbreak in San Diego. The outbreaks in Louisville and San Diego have sickened hundreds of people and killed two dozen over the past couple of years.
The hepatitis A virus infects the liver. Symptoms may include sudden onset of abdominal pain, diarrhea, nausea, vomiting, dark urine, tiredness, loss of appetite and/or headache followed by yellowing of the skin and eyes (jaundice). It could take several days or even weeks for an infected person to notice symptoms. Some infected people may never become symptomatic.
The virus is transmitted by feces, either by person to person contact or consumption of contaminated food or water, which is why infected restaurant workers and others in the food service industry are a major concern to public health authorities. Just one infected restaurant worker can expose hundreds of others to the virus.
The Nashville outbreak comes as Michigan grapples with the largest and deadliest hepatitis A outbreak in U.S. history. As of May 23, the outbreak, which is centered in the Detroit metropolitan area, had sickened at least 837 people, resulting in 671 hospitalizations and 27 deaths.
Indiana, West Virginia, and other parts of California beyond San Diego are also working to contain major hepatitis outbreaks there.