Ohio Increases Funding to Fight Hepatitis A Outbreak

The Ohio Department of Health is allocating $650,000 in additional state funding to fight the ongoing hepatitis A outbreak in the state, as case counts and the death toll continue to rise.

The 1 time commitment is to be shared with local health departments and will be divided up amongst areas of need. The application for funds is due back to the state by June 4, according to an Ohio Department of Health press release.

“It’s a new day in public health in Ohio as these funds are targeted to help local health departments prevent and control hepatitis A through education, surveillance, and vaccination of high- risk groups in our state,” Amy Action, MD, MPH, director of the Ohio Department of Health, said in a press release.

As of June 3, 2019, 2997 cases of hepatitis A have been reported in the state, with 79 of the total 88 counties reporting at least 1 case. Data indicate that 60% of cases have been in men between the ages of 1 and 89 years. Of the nearly 3000 cases reported, 1796 (60%) individuals have been hospitalized with 10 reported deaths, according to the Ohio Department of Health. As of June 3, 2019, Franklin County leads the state in the outbreak with 417 reported cases and Butler County is close behind, with 408 reported cases.

Further, all 5 states that Ohio borders—Michigan, Indiana, Kentucky, West Virginia, and Pennsylvania—have ongoing hepatitis A outbreaks.

In a previous interview with Contagion®, Donald Jensen, MD, a professor of medicine at Rush University Medical Center in Chicago, Illinois, stated that homelessness has emerged as a prominent risk factor in the ongoing hepatitis A outbreaks. According to Jensen: “Historically, outbreaks in the USA have been related to contaminated food (pomegranate seeds, raspberries, etc.) and to food handlers with hepatitis A virus (HAV). However, in the past few years there have been major outbreaks in California, Michigan, Utah and Kentucky in homeless individuals, those who use injection or non-injection drugs, and among men who have sex with men. Of these, homelessness has been a particularly prominent risk.”

At this time, 20 states have active hepatitis A outbreaks and outbreaks have been resolved in California and Utah, according to the US Centers for Disease Control and Prevention (CDC).

Currently, only 13 states require the hepatitis A vaccine in order to start kindergarten. Ohio currently does not require the vaccine to start kindergarten.

Jensen states that hepatitis A in children is not particularly dangerous, but vaccination is critical. “Children rarely have serious outcomes with HAV” Jensen said in a previous interview with Contagion®. “So the vaccination of children is largely to produce a generation of later- protected adults.”

Kentucky is experiencing the worst outbreak of hepatitis A in the nation with 4664 reported cases and 57 related deaths. In response, Kentucky has made the hepatitis A vaccine a requirement for school-aged children.

Ohio ranks second among overall case counts, and public health officials there indicate they will use the $650,000 to vaccinate high-risk groups.

However, in the previous interview, Jensen raised the concern that administering both doses of the hepatitis A vaccine to someone without a stable living condition could be extraordinarily difficult, especially if that individual does not have health insurance. However, 1 dose of the medication may be suitable for certain populations.

“The CDC has demonstrated, however, that even a single dose may provide long-lasting immunity and protection in the homeless population. This is obviously a logistical benefit and is cost-effective," Jensen says.

For up to date information on the hepatitis A outbreak and other viral outbreaks, be sure to check out the interactive Contagion® Outbreak Monitor.