Hepatitis A Overview
Hepatitis A infection is a vaccine-preventable illness. The primary mode of hepatitis A virus (HAV) transmission in the United States is typically person-to-person through the fecal-oral route (i.e., ingestion of something that has been contaminated with the feces of an infected person). Average incubation of HAV is 28 days, but illness can occur up to 50 days after exposure. A HAV-infected person can be viremic up to six weeks through their clinical course and excrete virus in stool for up to two weeks prior to becoming symptomatic, making identifying exposures particularly difficult. Illness from hepatitis A is typically acute and self-limited; however, when this disease affects populations with already poor health (e.g., hepatitis B and C infections, chronic liver disease), infection can lead to serious outcomes, including death. The best way to prevent hepatitis A infection is through vaccination with the hepatitis A vaccine. Additionally, practicing good hand hygiene—including thoroughly washing hands after using the bathroom, changing diapers, and before preparing or eating food—plays an important role in preventing the spread of hepatitis A.
Current Situation and Risk Groups
Over the past year, multiple counties in Florida have reported an increasing number of HAV infections. Since January 2018, 1,293 cases of HAV infection have been reported statewide. Compared to an average of 120 cases per year from 2012-2016. Over 90% of these recent cases do not have international travel exposures. Over 70% of recent cases in Florida have required hospitalization. Although infections have occurred across all demographic groups, approximately 65% of the recent cases are among males. The median age of cases is 37 years and the highest rates of disease are among persons 30-49 years. Common risk factors include injection and non-injection drug use, homelessness, and men having sex with men (MSM).
Current Prevention Activities
Although St. Lucie County has only had two reported cases of hepatitis A this year, the Florida Department of Health in St. Lucie County (DOH-St. Lucie) is instituting efforts to ensure St. Lucie County does not see an increase in local cases in the future. Information has been sent to our local community medical providers regarding the current situation and recommendations from the Advisory Committee on Immunization Practices was sent to providers to help determine whom to vaccinate. Now, efforts will focus on vaccinating and educating our population that is at higher risk of becoming infected. The targeted risk groups include: people experiencing homelessness, people with any history of illicit drug use, and MSM.
High-Risk Group Targeted Vaccination Plan
The goal is to vaccinate 80% of St. Lucie’s high-risk residents. To accomplish that goal, DOH-St. Lucie will work in conjunction with government agencies, community social service organizations, and continue to provide direct services.
- Government agency partnerships:
- The St. Lucie County jail’s contracted medical provider is currently working with DOH-St. Lucie on a plan/program to administer vaccinations to inmates.
- DOH-St. Lucie will work with St. Lucie Community Services and Veteran’s Affairs offices to conduct point of dispensing vaccination clinics targeting high-risk populations.
- Community social services partners:
- Several local social service organizations provide hot meals, mobile showers, and other services at various locations around the county to those in need or experiencing homelessness. The goal is to join the efforts and work in conjunction with existing services to provide education and vaccines.
- Direct services from DOH-St. Lucie:
- Will continue to provide free hepatitis A and B vaccines to high-risk clients.
- Will hold several test/educate/vaccinate community outreach events targeting high-risk individuals.
- Will schedule vaccination clinics in conjunction with services already begin provided in the community.