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Hepatitis A Still Spreading Through The US

From Patricia Doyle PhD
veteranstoday.com
1-29-18

 
Hello Jeff, If you read below there are also new cases in Oregon, especially among food workers.  NY as well.

 Patty

 HEPATITIS A - USA (05): (MICHIGAN, UTAH, CALIFORNIA)

 ****************************************************
 A ProMED-mail post
 http://www.promedmail.org
 ProMED-mail is a program of the
 International Society for Infectious Diseases
 http://www.isid.org

 In this posting:
 [1] Michigan
 [2] Utah
 [3] California (San Diego County)

 ******
 [1] Michigan
 Date: Fri 26 Jan 2018
 Source: Michigan Department of Health & Human Services (MDHHS) [edited]
 http://www.michigan.gov/mdhhs/0,5885,7-339-71550_2955_2976_82305_82310-447907--,00.html


 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 state. Since the beginning of the outbreak in August 2016, public health response has included increased healthcare awareness efforts, public notification and education, and outreach with vaccination clinics for high-risk populations. No common sources of food, beverages, or drugs have been identified as a potential source of infection. Transmission appears to be through direct person-to-person spread and illicit drug use. Those with history of injection and non-injection drug use, homelessness or transient housing, and incarceration are thought to be at greater risk in this outbreak setting. Notably, this outbreak has had a high hospitalization rate.

 Michigan Hepatitis A Outbreak Cases and Deaths as of 24 Jan 2018

 Cases \ Hospitalizations \ Deaths
 715 \ 582 (81.4%) \ 24 (3.4%)

 --
 Communicated by:
 ProMED-mail
 <promed@promedmail.org

 [Cumulative case data
 Report date / Cases / Deaths / New cases per week
 26 Jun 2017 / 190 / 10 /
 15 Sep 2017 / 319 / 14 /
 6 Oct 2017 / 376 / 14 /
 13 Oct 2017 / 397 / 15 / 21
 20 Oct 2017 / 431 / 17 / 34
 27 Oct 2017 / 457 / 18 / 26
 3 Nov 2017 / 486 / 19 / 29
 10 Nov 2017 / 495 / 19 / 9
 17 Nov 2017 / 509 / 20 / 14
 29 Nov 2017 / 555 / 20 / 23
 20 Dec 2017 / 630 / 20 / 25
 4 Jan 2018 / 658 / 22 / 14
 10 Jan 2018 / 677 / 22 / 19
 24 Jan 2018 / 715 / 24 / 19

 Cumulatively, 14.3 percent of the total males are MSM, 3.0 percent of the total are healthcare workers, and 4.2 percent of the total are food handlers. More cases continue to occur, spreading north and west of the main southeastern Michigan focus of the outbreak. The total cases continue to increase and have altogether in numbers and in fatalities surpassed the numbers of the now essentially over southern California outbreak. - Mod.LL]

 ******
 [2] Utah
 Date: Mon 22 Jan 2018
 Source: Utah Department of Health [edited]
 http://health.utah.gov/epi/diseases/hepatitisA/HAVoutbreak_2017


 Outbreak-Associated Cases 154
 Onset Date Range 8 May 2017 - 15 Jan 2018  
 Age Range 22 - 71 years (median age 38 years)
 Sex
 Male 99 71.2%
 Female 55 39.6%

 Health Jurisdictions / Cases / Incidence Rate per 100 000 Person-Years
 Salt Lake County / 104 (67.5%) / 9.81
 Utah County / 35 (22.7%) / 6.25
 Bear River / 5 (3.2%) / 2.97
 Southwest Utah / 3 (1.9%) / 1.39
 Davis County / 1 (0.6%) / 0.31
 Central Utah / 2 (1.3%) / 2.69
 Tooele / 1 (0.6%) / 1.63
 Weber-Morgan / 2 (1.3%) / 0.82
 Wasatch / 1 (0.6%) / 0.00

 Hospitalizations 81 (55.9%)

 Deaths 0 (0.0%)

 Risk Factors
 Homelessness and Drug Use 65 (46.8%)
 Drug Use 36 (25.9%)
 Homelessness 14 (10.1%)
 Epi-Linked 24 (17.3%)
 Travel 4 (2.9%)
 Unknown 8 (5.8%)

 Incarcerated 30 (21.6%)

 Co-infection
 Hepatitis B (HBV) 13 (9.4%)
 Hepatitis C (HCV) 33 (23.7%)
 HBV & HCV 10 (7.2%)

 --
 Communicated by:
 ProMED-mail
 <promed@promedmail.org

 [Cumulative case data:
 Date reported / Cases
 2 Oct 2017 / 36
 13 Nov 2017 / 75
 4 Dec 2017 / 91
 18 Dec 2017 / 110
 2 Jan 2018 / 124
 8 Jan 2018 / 133
 22 Jan 2018 / 154. - Mod.LL]

 ******
 [3] California (San Diego County)
 Date: Tue 23 Jan 2018
 Source: San Diego County Health & Human Services Agency [edited]
 http://www.sandiegocounty.gov/content/sdc/hhsa/programs/phs/community_epidemiology/dc/Hepatitis_A.html


 San Diego County Hepatitis A Outbreak Cases and Deaths:
 Data reported through 17 Jan 2018 and posted on 23 Jan 2018

 Cases Deaths Hospitalizations
 577 / 20 (3.5%) / 395 (68.5%)

 --
 Communicated by:
 ProMED-mail Rapporteur Mary Marshall

 [The southern California outbreak appears to be over due to the change in control paradigm taken by the public health officials.

 Cumulative case data
 Report date / Cases / Hospitalized (percentage) / Deaths (percentage) / New cases per week
 5 Apr 2017 / 39 / 33 (85) / 1 (3)
 4 May 2017 / 80 / 66 (83) / 3 (4) / 10
 31 May 2017 / 133 / 103 (80) / 3 (2) / 14
 12 Jun 2017 / 160 / 120 (75) / 4 (2.5) / 18
 27 Jun 2017 / 196 / 142 (72) / 4 (2) / 20
 26 Jul 2017 / 275 / 194 (71) / 7 (2.5) / 20
 1 Aug 2017 / 295 / 202 (68) / 10 (3.4) / 17
 8 Aug 2017 / 312 / 215 (69) / 10 (3.2) / 21
 15 Aug 2017 / 333 / 232 (70) / 11 (3.3) / 19
 22 Aug 2017 / 352 / 246 (70) / 14 (4) / 26
 29 Aug 2017 / 378 / 263 (70) / 15 (4) / 26
 5 Sep 2017 / 398 / 279 (70) / 15 (3.8) / 20
 12 Sep 2017 / 421 / 292 (69) / 16 (3.8) / 23
 19 Sep 2017 / 444 / 305 (69) / 16 (3.6) / 23
 26 Sep 2017 / 461 / 315 (68) / 17 (3.7) / 17
 3 Oct 2017 / 481 / 337 (70) / 17 (3.5) / 20
 10 Oct 2017 / 490 / 342 (70) / 18 (3.7) / 9
 17 Oct 2017 / 507 / 351 (69) / 19 (3.7) / 17
 31 Oct 2017 / 536 / 369 (69) / 20 (3.7) / 29 (10 days)
 7 Nov 2017 / 544 / 372 (68) / 20 (3.7) / 8
 14 Nov 2017 / 546 / 369 (68) / 20 (3.7) / 2
 4 Dec 2017 / 567 / 382 (67) / 20 (3.5) / 7
 18 Dec 2017 / 571 / 390 (68) / 20 (3.5) / 2
 2 Jan 2018 / 577 / 396 (68) / 20 (3.5) / 3
 23 Jan 2018 / 577 / 395 / 20 / 0.

 Maps of (Michigan, United States): http://healthmap.org/promed/p/225,
 (Utah, United States): http://healthmap.org/promed/p/246 and
 (California, United States): http://healthmap.org/promed/p/204. - Mod.LL]

 See Also
 Hepatitis A - USA (04): (MI,KY) 20180115.5559179
 Hepatitis A - USA (03): (UT) 20180111.5552496
 Hepatitis A - USA (02): (CA,MI,UT) 20180108.5544747
 Hepatitis A - USA: (HI) 20180107.5543399
 2017
 ----
 Hepatitis A - USA (62): (MI, UT) 20171231.5530386
 Hepatitis A - USA (61) 20171224.5522033
 Hepatitis A - USA (60): (WY) 20171223.5521171
 Hepatitis A - USA (59): (CA,MI,UT) 20171211.5490041
 Hepatitis A - USA (58): (KY) 20171122.5459962
 Hepatitis A - USA (57): (MI,UT) vaccine shortage 20171120.5452198
 Hepatitis A - USA (56): (MI) western spread 20171117.5448927
 Hepatitis A - USA (55): (CA, UT) 20171116.5445389
 Hepatitis A - USA (54): (MI, CA) 20171112.5439275
 Hepatitis A - USA (53): (CA) fatal 20171107.5429761
 Hepatitis A - USA (52): (MI) fatal 20171106.5426879
 Hepatitis A - USA (51): (CA,MI) 20171101.5417867
 Hepatitis A - USA (50): (CA, CO) 20171031.5416392
 Hepatitis A - USA (49): (MI) fatal 20171030.5413115
 Hepatitis A - USA (48): (MI) increase in MSM cases 20171027.5408410
 Hepatitis A - USA (47): (MI) fatal 20171020.5394454
 Hepatitis A - USA (46): (CA) fatal 20171017.5386460
 Hepatitis A - USA (45): (CA) state emergency declaration 20171015.5381931
 Hepatitis A - USA (44): (MI) fatal 20171014.5380907
 Hepatitis A - USA (43): (CA) fatal 20171010.5371293
 Hepatitis A - USA (42): (CA, AZ) 20171009.5367581
 Hepatitis A - USA (41): (MI) 20171009.5368478
 Hepatitis A - USA (40): (CA,UT) 20171006.5362839
 Hepatitis A - USA (39): (CA, AZ) 20171004.5355999
 Hepatitis A - USA (38): (NY) MSM 20171001.5350449
 Hepatitis A - USA (37): (CA,UT) comparative statistics 20170928.5346641
 Hepatitis A - USA (36): (CA) fatal 20170926.5340064
 Hepatitis A - USA (35): (MI) fatal 20170924.5337251
 Hepatitis A - USA (34): (NYC) MSM 20170922.5333091
 Hepatitis A - USA (33): (UT), RFI 20170921.5331515
 Hepatitis A - USA (32): (CA) 20170920.5328456
 Hepatitis A - USA (31): (CA) fatal 20170919.5326206
 Hepatitis A - USA (30): (MI) fatal 20170916.5321042
 Hepatitis A - USA (29): (CA) fatal 20170915.5318707
 Hepatitis A - USA (28): (CA) fatal, RFI 20170914.5313869
 Hepatitis A - USA (28): (CA) fatal 20170912.5312226
 Hepatitis A - USA (26): (CA) fatal 20170906.5298571
 Hepatitis A - USA (25): (CA) fatal, governmental responses 20170902.5291024
 Hepatitis A - USA (24): (CO) 20170831.5286610
 Hepatitis A - USA (23): (CA) fatal 20170829.5281598
 Hepatitis A - USA (22): (CA) fatal 20170822.5267753
 Hepatitis A - USA (21): (MI) RFI 20170817.5256404
 Hepatitis A - USA (20): (CA) fatal 20170817.5256184
 Hepatitis A - USA (19): (CA) fatal 20170815.5252338
 Hepatitis A - USA (18): (CA) fatal 20170809.5238557
 Hepatitis A - USA (17): (CA) fatal 20170802.5222462
 Hepatitis A - USA (16): (CO) 20170730.5215580
 Hepatitis A - USA (15): (CA) fatal 20170726.5205912
 Hepatitis A - USA (14): (CO) RFI 20170725.5201341
 Hepatitis A - USA (13): (CA) fatal 20170713.5173051
 Hepatitis A - USA (12): (MI) fatal, RFI 20170707.5158430
 Hepatitis A - USA (11): (CA) 20170629.5139711
 Hepatitis A - USA (10): (CA) additional counties, RFI 20170615.5107437
 Hepatitis A - USA (09): (CA) 2nd county, RFI 20170614.5105051
 Hepatitis A - Europe, Americas: MSM, WHO alert 20170614.5105578
 Hepatitis A - USA (08): (CA) fatal, RFI 20170613.5102106
 Hepatitis A - USA (07): (CA) fatal 20170606.5087079
 Hepatitis A - USA (06): (CO) MSM 20170512.5031179
 Hepatitis A - USA (05): (CA) fatal 20170511.5028824
 Hepatitis A - USA (04): (CA) fatal, RFI 20170506.5017836
 Hepatitis A - USA (03): (OR) food workers 20170410.4959609
 Hepatitis A - USA (02): (CA) fatalities 20170408.4956398
 Hepatitis A - USA: (MI) increased incidence 201703
 .................................................ll/ec/mpp