Public health officials and the Michigan Department of Health and Human Services (MDHHS) are continuing to see an elevated number of hepatitis A cases in the city of Detroit, and counties of Macomb, Oakland, and Wayne.

“Together with our local health partners, we are increasing outreach to vulnerable populations to raise awareness and promote vaccination of hepatitis A,” said Dr. Eden Wells, chief medical executive of MDHHS. “Those who live, work, or play in the city of Detroit, as well as Macomb, Oakland, and Wayne counties are urged to get vaccinated for hepatitis A and talk to their healthcare provider about their risks.”

From August 1, 2016 to March 21, 2017, 107 cases of lab-confirmed hepatitis A have been reported to public health authorities in these jurisdictions. This represents an eightfold increase during the same time last year. Ages of the cases range from 22 to 86 years, with an average age of 45 years. The majority of the cases have been male. Eighty-five percent of the cases have been hospitalized with two deaths reported.  Approximately one-third of the cases have a history of substance abuse, and 16 percent of all cases are co-infected with hepatitis C. No common sources of infection have been identified.

Hepatitis A is a vaccine-preventable disease. While the hepatitis A vaccine is recommended as part of the routine childhood vaccination schedule, most adults have not been vaccinated and may be susceptible to the hepatitis A virus.

Hepatitis A vaccination is recommended for:

  • All children at age 1 year
  • Close personal contacts (e.g., household, sexual) of hepatitis A patients
  • Users of injection and non-injection illegal drugs
  • Men who have sex with men
  • People with chronic (lifelong) liver diseases, such as hepatitis B or hepatitis C. Persons with chronic liver disease have an elevated risk of death from liver failure
  • People who are treated with clotting-factor concentrates
  • Travelers to countries that have high rates of hepatitis A
  • Family members or caregivers of a recent adoptee from countries where hepatitis A is common

Individuals with hepatitis A are infectious for 2 weeks prior to symptom onset. Symptoms of hepatitis A include jaundice (yellowing of the skin), fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, and light-colored stools. Symptoms usually appear over a number of days and last less than 2 months; however, some people can be ill for as long as 6 months. Hepatitis A can sometimes cause liver failure and death.

Risk factors for a hepatitis A infection include living with someone who has hepatitis A, having sexual contact with someone who has hepatitis A, or sharing injection or non-injection illegal drugs with someone who has hepatitis A. The hepatitis A virus can also be transmitted through contaminated food or water.

MDHHS encourages residents in the city of Detroit and Macomb, Oakland, and Wayne counties to check their hepatitis A vaccination status and talk to their healthcare provider about their risks for hepatitis A.