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Michigan Hepatitis A Outbreak

Starting in August 2016, a person-to-person outbreak of hepatitis A was identified in Michigan. Incidence of new cases in Southeast Michigan was shown to be well above the expected baseline for late summer/early fall of 2016, with sustained transmission spreading out from the region to the rest of the state. Transmission was determined to be highest among people with illicit drug use and/or those experiencing homelessness or transient living. Public health response has included increased healthcare awareness efforts, public notification and education, and outreach with vaccination clinics for high-risk populations (e.g., history of injection and non-injection drug use, homelessness or transient housing, incarceration). Of note, this outbreak had a high hospitalization rate among those infected.  With an observed decrease in reported hepatitis A cases across Michigan in late 2019, and a low baseline of activity throughout 2020 & 2021, MDHHS no longer considers Michigan to be in a statewide outbreak. MDHHS will continue to monitor statewide hepatitis A activity, and efforts for prevention will be sustained, especially for vaccination of at-risk populations. More descriptive data on the outbreak can be found within the Comprehensive Summary.
 

Michigan Hepatitis A Outbreak Cases and Deaths as of February 5, 2020*
*Table will be updated weekly by 4:00pm each Friday

Cases

Hospitalizations

Deaths

920

738 (80.2%)

30 (3.3%)

Please note: Table does not include all reported hepatitis A cases in the outbreak region; only those cases that are identified as outbreak-related. More descriptive data on the current outbreak can be found within the Comprehensive Summary.  Data are provisional and subject to change.

 

Confirmed Cases Referred August 1, 2016 - February 5, 2020
Meeting the MI Hepatitis A Outbreak Case Definition

County (or city)

Total Cases

County (or city)

Total Cases

Macomb†

223

Gratiot†

3

City of Detroit†

173

Midland

3

Wayne†

164

Allegan†

2

Oakland†

120

Cass†

2

St. Clair†

33

Mecosta†

2

Ingham†

30

Bay†

1

Genesee†

28

Charlevoix†

1

Shiawassee†

22

Clare†

1

Washtenaw†

20

Hillsdale†

1

Monroe†

18

Huron†

1

Calhoun†

10

Ionia†

1

Isabella†

8

Leelanau†

1

Lapeer†

7

Lenawee†

1

Clinton†

6

Missaukee†

1

Livingston†

6

Newaygo

1

Sanilac†

6

Schoolcraft

1

Eaton†

6

St Joseph†

1

Saginaw†

5

Van Buren

1

Grand Traverse

4

Other*

2

Kent

4

† Indicates no confirmed case in the past 100 days

*Jackson Michigan Department of Corrections

Indicates counties with outbreak-associated cases that are not currently included in the outbreak jurisdiction

Hepatitis A Overview

Hepatitis A is a serious, highly contagious liver disease caused by the hepatitis A virus (HAV). HAV is found in the feces (poop) of people with hepatitis A. You can get hepatitis A by eating contaminated food or water, during sex, or just by living with an infected person. Illness can appear 15-50 days after exposure and you can be sick for several weeks. In some cases, people can die. Although not all people infected with hepatitis A experience illness, symptoms can include:

  • Jaundicenausea and vomiting
  • belly pain
  • feeling tired
  • fever
  • loss of appetite
  • yellowing of the skin and eyes
  • dark urine
  • pale-colored feces (poop)
  • joint pain

There are steps you can take to reduce the risk of Hepatitis A transmission. Hepatitis A is a vaccine-preventable illness. While the hepatitis A vaccine is recommended as a part of the routine childhood vaccination schedule, most adults have not been vaccinated and may be susceptible to the hepatitis A virus. The best way to reduce the risk of getting hepatitis A is to get vaccinated with two doses of Hepatitis A vaccine. It is also recommended to wash your hands after going to the bathroom and before preparing meals for yourself and others. Use your own towels, toothbrushes, and eating utensils. Do not have sex with someone who has HAV infection or share food, drinks, or smokes with other people.

What can the public do to protect themselves and their communities?

  • Get vaccinated against hepatitis AHandwashing
  • Wash hands after using the restroom and before eating or preparing meals for yourself or others
  • Use your own towels, toothbrushes, and eating utensils
  • Do not have sex with someone who has HAV infection
  • Do not share food, drinks, drugs, or smokes with other people
  • If you think you may have hepatitis A, see your medical provider
  • If you have hepatitis A, please cooperate with your local public health to help protect others

Vaccination Information

Hepatitis A can be prevented with a safe and effective vaccine. Stop the spread of this infection.

Who Should Get the HAV Vaccine?

  • Persons who are homeless.
  • Persons who are incarcerated.
  • Persons who use injection and non-injection illegal drugs.
  • Persons who work with the high risk populations listed above.
  • Persons who have close contact, care for, or live with someone who has HAV.
  • Persons who have sexual activities with someone who has HAV.
  • Men who have sex with men.
  • Travelers to countries with high or medium rates of HAV.
  • Persons with chronic liver disease, such as cirrhosis, hepatitis B, or hepatitis C.*
  • Persons with clotting factor disorders.

*Note: individuals with chronic liver disease (e.g., cirrhosis and hepatitis C) may not be at increased risk of getting HAV infections but are at increased risk of having poor outcomes if they are infected with HAV.

For information on where to get vaccinated:

Protect Yourself and Get Vaccinated Against Hepatitis A: Find a Local Clinic Near You Today - Hep A Clinic Calendar

If you (or someone you know) do not have health insurance, you will likely qualify for free or low cost vaccines. Talk with your local health department to find out if you qualify. For additional information, contact the MDHHS Division of Immunization at 517-335-8159.