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Hepatitis A Outbreak in Michigan: Ten Times More Cases in 2017 Than 2015

An outbreak of Hepatitis A in Michigan that began in August 2016 has seen the number of cases reported in 2017 increase by a factor of ten since 2015, the last full year of reporting prior to the current outbreak.

According to the Michigan Department of Health, 553 cases of Hepatitis A have been reported in Southeast Michigan alone in 2017, compared to only 51 in the entire state in 2015.

The Centers for Disease Control (CDC) reported that there were 1,390 cases of Hepatitis A in the United States in 2015, or 0.4 per 100,000 residents of the United States.

Michigan reported 51 cases of Hepatitis A that year, enough to put it in the top ten states, but well behind California, which reported 179 cases; Texas, which reported 143 cases; and New York, which reported 123 cases.

This year, which still has two more weeks to go, is an entirely different matter, with Michigan already reporting more than 500 cases of Hepatitis A, according to the Detroit Free Press, ten times more than the number of cases reported in the state in 2015.


Disease Dailyreported last week:

Hepatitis A is an infection caused by the Hepatitis A virus, and is typically transmitted through the fecal-oral route or consuming contaminated food or water. Symptoms of the infection include fatigue, lack of appetite, nausea, diarrhea and jaundice; symptoms can last up to two months after the initial infection. Hepatitis A is a vaccine-preventable disease. These outbreaks have been severe, with over 80% of cases requiring hospitalization.

The specific strain of Hepatitis A virus (genotype IB) is not commonly seen in the U.S., but is rather common in the Mediterranean, Turkey and South Africa. The initial source of the outbreaks among these states is unknown, but several states have linked cases serologically,” Disease Dailynoted. (emphasis added)

“An alarming number of hepatitis A cases have swept across southeast Michigan since August 2016 in what public health officials said is one of the largest outbreaks to occur in the United States since a vaccine was widely introduced two decades ago. In 2017 alone, Michigan has led the nation in hepatitis cases per capita, according to a Free Press analysis. More than 500 cases have been reported this year.” the Detroit Free Pressreported last week:

Detroit and Macomb County have the highest rate of outbreak related cases at about 2 cases per 10,000 residents.

The cause of the outbreak is not yet known but officials say they’re probing a link to the ongoing opioid and heroin crisis seen across Michigan, as well as other potential exposure routes.

“We’re continuing to see new cases almost every day so it is a concern,” said Macomb County Health Department Director Bill Ridella. “I think there is a strong connection to a number of these cases with the opioid and heroin problem. About half of the cases in Macomb County has some connection with drug use and/or heroin.”

But state officials said since other exposure routes have been found, it hasn’t been easy to discern the exact origin.

“Typically what we would see this time of year is about 14 times lower than what we’re currently dealing with,” said Angela Minicuci, Michigan Department of Health and Human Services spokesperson. “I don’t know if we’ve seen a hepatitis A outbreak like this before.”

“In 2017, several states have experienced acute outbreaks of Hepatitis A, namely Michigan, Kentucky, Utah, Colorado, and California. Each state varies in regards to outbreak onset and population affected, but one similarity has emerged among these states where those experiencing homeless and people who inject drugs (PWID) have been the largely affected population,” Disease Dailyreported last week.

In these five states alone, 1,430 cases of Hepatitis A have been reported so far in 2017, more than the 1,390 cases that were reported in the entire United States in 2015. Data on rates of Hepatitis A in the rest of the United States for 2017 is not yet available.

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