The Grapevine

Hepatitis A Outbreak In Nashville: Symptoms, Risk Factors To Watch Out For

Tennessee is the latest U.S. state to report a hepatitis A outbreak. In a press release, the Metro Public Health Department (MPHD) confirmed 14 cases in Nashville since December 2017.

Hepatitis A is a contagious infection which causes an inflammation of the liver. It is typically caused by the hepatitis A virus which spreads to people who come into contact with an infected person or contaminated objects, food, drinks etc. In some cases, the inflammation may be triggered by excessive drinking over a long period.

While children who are under 6 years of age do not have symptoms, older children and adults can experience yellowing of the skin and eyes, loss of appetite, fever, fatigue, vomiting, body pain, dark urine, and pale stools.

"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," said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center, Nashville. "That's why hepatitis A is so very hard to figure out from a public health perspective. You're always running behind the virus, you're always trying to catch up."

According to the Centers For Disease Control and Prevention (CDC), rates have declined by more than 95 percent since 1995, when the hepatitis A vaccine first became available. However, many states across the country have reported a rise in cases since 2017.

Over the past two years, outbreaks occurred in California, Indiana, Kentucky, Michigan, Utah, Arizona and West Virginia. As many as 837 cases were reported in Michigan since May 2016 while 704 cases were reported in California since November 2016.

People who are most at risk of developing hepatitis A include homeless individuals, men who have sex with other men, recreational drug users, those with a chronic liver disease or clotting-factor disorders, and people who travel to countries where the virus is common. The Advisory Committee on Immunization Practices (ACIP) recommended vaccination for all children at the age of 1 as well as those at risk.

CDC spokeswoman Kristen Nordlund stated that the supply of vaccines has now been replenished after a national shortage in early 2018. While the supply is sufficient to meet the demand for both children and adults, people may need to talk to their doctors and check if they have stocks of the vaccine, she said.

Regarding the outbreak, health experts assure that a majority of patients experience a complete recovery. 

"There’s a very, very slim chance that a hepatitis A infection would lead to serious complications," said Dr. Nicholas Gilpin, chief medical officer of Beaumont Hospital, Grosse Pointe. "About 1 percent of cases will go on to liver failure, which means you would require a transplant. In the majority of cases, you feel sick for a period of time and then you get better."