No end in sight for hepatitis A emergency in Philadelphia

Philadelphia’s hepatitis A outbreak has risen to nearly 200 cases, as a city health official said the recently declared public-health emergency could last for months.

The number of confirmed cases this year stood at 196 as of last Friday, said Dr. Steven Alles, Philadelphia’s director of disease control. Typically, the city sees two to six cases per year. Several more possible cases are being investigated.

There is not one particular hot spot of infection in Philly. “We are seeing cases presented from all over the city,” Alles told Metro. Most of the cases are in people who report using drugs or being homeless. But in a third of the infections, risk factors are unknown.

The city’s disease control department has targeted those high-risk groups. Staffers maintain a presence in McPherson Square and Prevention Point and have administered 2,500 Hepatitis A vaccinations. “But it is not enough,” said Alles.

After rising sharply each month this year, the number of reported cases has stabilized — 21 in May, 53 in June, 83 in July, with a similar number expected for August. “It’s leveling off at a new, very high rate,” said Alles. “We’re not anywhere near lifting this emergency declaration, because cases continue to be reported. This is going to continue for weeks, possibly even months. I’d estimate, if we’re lucky, December.”

Hepatitis A is a liver infection caused by a virus. It is most often transmitted through sex or contact with an infected person’s blood or feces. The disease can also spread when food-service workers don’t adequately wash their hands after using the restroom.

The city declared the public-health emergency on Aug. 1. It enabled officials to request more funding from the state and federal governments for vaccines and outreach, such as boosting vaccine stockpiles in emergency departments and paying for contract nurses to administer vaccinations.

“Primarily what we’re hoping to get out of the declaration is a call to action, primarily among the health-care community, to raise awareness of the emerging situation and to expand their ability to provide preventative services, identify cases and report them,” said Alles. “But more importantly, to ramp up providing vaccines to those most at risk.”

On Monday, Pennsylvania Gov. Tom Wolf allotted $50,000 to fund additional vaccines and outreach efforts across the state. Most of the cases have been reported in Philadelphia and Bucks County. “We must do everything in our power to prevent hepatitis A from further spreading across the commonwealth,” he said in a statement. “This funding will help us provide vaccines and outreach to the communities hardest hit by this outbreak.”

Philadelphia is not alone in dealing with a surge in hepatitis A. Twenty-nine states are experiencing outbreaks. According to the Centers for Disease Control, 23,600 cases of hepatitis A have been reported nationwide since 2016, with 230 deaths. Health officials fear the opioid crisis might be driving the outbreak, since the disease can be spread through needles.

Alles said people in high-risk groups — men who have sex with men, people who travel internationally, homeless people and drug users — should get the hepatitis A vaccine. “But if somebody is not one of those people and don’t have other risk factors, right now the best prevention is really good hygiene and awareness,” he said. “They can also ask their clinical provider about getting vaccinated. There’s nothing wrong with that.”