Twenty-five health departments in Michigan, including all Upper Peninsula Health Departments, will each recieve a $20,000 grant for the prevention of hepatitis A in light of Michigan’s outbreak. The aim of the grant funding is to improve outreach and vaccination to populations that are at high-risk for contracting hepatitis A. (Photo courtsey of Pixabay)photo: https://pixabay.com/en/vaccination-doctor-syringe-medical-1215279/

By CECILIA BROWN

Journal Staff Writer

MARQUETTE — In light of the largest person-to-person hepatitis A outbreak in Michigan’s recorded history, 25 health departments in the state, including all Upper Peninsula health departments, will each receive a $20,000 grant from the Michigan Department of Health and Human Services.

The funding was provided to improve outreach and vaccinations to high-risk populations in counties outside of the jurisdiction of the outbreak­­­, which began in August 2016. The 20 health departments in the outbreak jurisdiction have already been awarded $2.5 million, part of a $7.1 million allocation approved by the Michigan Legislature in late 2017 to address the outbreak, according to the MDHHS.

“This has been the largest person-to-person hepatitis A outbreak in Michigan’s history, with more than 780 cases,” said Dr. Eden Wells, MDHHS chief medical executive. “Increasing vaccination outreach to high-risk populations across the state is essential to stopping the spread of hepatitis A in Michigan.”

Dr. Teresa Frankovich, who acts as medical director of several U.P. health departments, including Marquette County, said the health department officials are coordinating a game plan with other agencies and organizations that serve the high-risk populations.

“(The goal is) basically to take those populations that are at most risk to come into contact with the virus and provide protection,” she said.

Providing high-risk groups with the vaccination — which Frankovich said is 95 percent effective, with an “expectation of long-term immunity” — is important for the health of those populations, as well as the community in general.

“These are higher-risk individuals for getting ill and they want to prevent that, but it’s important to remember because of the way that hepatitis A is spread, it can impact an entire community if the infection is circulating,” she said.

As of March 21, 789 cases of hepatitis A had been identified as outbreak-related in Michigan, with 635 hospitalizations and 25 deaths reported, according to MDHHS data.

However, many of the outbreak-related cases are concentrated in Lower Peninsula counties, with only one case reported in the U.P., in Schoolcraft County, according to the March 21 data from MDHHS.

“There’s only been one case to date in the U.P. that has been outbreak associated. We’d like it remain that way,” Frankovich said. “It’s much easier to prevent an outbreak than address it once it’s begun.”

Especially an outbreak that has led to more hospitalizations than usual for hepatitis A.

“Routinely, people can become quite ill, but generally recover well for hepatitis A,” Frankovich said. “This outbreak has been notable for the fact that people have been ill enough to be hospitalized in large numbers. It’s very hard … it’s unusual to have hepatitis A have this kind of hospitalization and death rate; it’s very sobering.”

People may wonder if the increased hospitalization rate is due to a particularly virulent strain of hepatitis A with this outbreak. However, it “doesn’t appear to be a particular strain that’s more virulent,” Frankovich said. “(It) may be an interplay between the vulnerabilities of people being infected and the hepatitis A virus itself.”

High-risk populations include people with a chronic liver disease; a history of injection and/or non-injection drug use, incarceration, homelessness or transient housing; and men who have engaged in sex with men, according to the MDHHS.

The hepatitis A virus is found in the feces of infected individuals and spread by consuming contaminated food or water, sexual intercourse with an infected person, or living with an infected person. The disease is not transmitted by coughing or sneezing.

Symptoms of hepatitis A can include yellowing of the skin and eyes, nausea and vomiting, belly pain, loss of appetite, pale-colored feces, dark urine, joint pain, fever and feeling tired, according to the MDHHS.

The hepatitis A virus causes inflammation of the cells in the liver, which can affect liver function. In rare cases, it can lead to a sudden loss of liver function in those with chronic liver disease or older adults, but most people who are infected “recover completely with no permanent liver damage,” according to the Mayo Clinic.

However, there is no specific “curative therapy” for hepatitis A — management of the condition generally involves supportive care and medical treatment for serious complications that result from the disease, according to the Mayo Clinic.

Health care professionals say it is important to prevent infection by practicing effective hand-washing procedures, receiving the hepatitis A vaccine — which is routinely recommended for children to receive between ages 1 and 2 — and avoiding sex with partners who are infected with the disease.

While officials expect the outbreak to take time to resolve, they feel fortunate there is an effective vaccine for hepatitis A.

“There are some things that circulate that we can’t provide protection for. In this instance, we can; it’s really completely preventable with vaccination,” Frankovich said. “It’s excellent to be faced with a problem for which there is a solution.”

Officials said that while the focus of the grant is on high-risk populations, anyone who wishes to get vaccinated can contact their local health department, pharmacies or health care providers.

For more information about hepatitis A, including a calendar of vaccination clinics, visit Michigan.gov/hepatitisAoutbreak.

Cecilia Brown can be reached at 906-228-2500, ext. 248. Her email address is cbrown@miningjournal.net.