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Hepatitis A Outbreak Public Health Response Overview

As cases of hepatitis A have continued to rise, the Michigan Department of Health and Human Services (MDHHS) activated the Community Health Emergency Coordination Center (CHECC) on October 31, 2017 to coordinate the response of the jurisdictions involved in the outbreak. The State Emergency Operations Center (SEOC) was active from November 2017 through January 2018 to help coordinate the multiple state agency responses to the hepatitis A outbreak. 

Transmission Mitigation and Surveillance Strategies

MDHHS and local public health have participated in multiple meetings to discuss outbreak activities related to case-finding, contact tracing, post-exposure prophylaxis (i.e., immunoglobulin and hepatitis A vaccine), notification to high risk facilities, and mass vaccination strategies. Prompt identification and interview of new cases help to determine exposure to hepatitis A and close contacts allowing for timely administration of post-exposure prophylaxis to prevent further transmission. The MDHHS Communicable Disease Division has developed a supplemental questionnaire that is being used by public health investigators to identify high risk groups and to better direct public health interventions. Because of the high number of cases being reported, the MDHHS OutbreakNet Enhanced student interviewing team has assisted some counties with interviewing case-patients. Clinical specimens are also being requested from clinical laboratories to be submitted to the State Laboratory for further testing at the Centers for Disease Control and Prevention. The testing identifies which cases are part of the outbreak allowing public health to track any changes of outbreak-associated risk factors.

Community Vaccination Clinics

MDHHS and local public health have conducted timely interviews to identify close contacts necessary to administer post-exposure prophylaxis and mitigate further transmission. Despite this significant collective effort, the outbreak persists. To end this outbreak, vaccination rates need to be increased among the highest risk individuals. Working with community partners, vaccination efforts are being implemented in targeted locations such as homeless shelters, soup kitchens, and rehabilitation facilities. Partnerships are also being developed with area Emergency Departments, county jails and state prisons.   

Local Health Departments are working with correctional facilities for Hepatitis A screening and vaccinations.

Community Partners

Press Releases

Michigan Health Alert Network (MIHAN) Messages