HJLR Nov/Dec 2018

46 NOV / DEC 2018 I  Healthcare Journal of LITTLE ROCK dialogue column Director’s Desk Hepatitis: An Outbreak Reinforces the Importance of Vaccination Hepatitis (hep) A, B, and C are themost common hepatitis viruses in the United States.Although each can cause similar symptoms, hep A, B, and C are caused by three different viruses that have different modes of transmission. Whereas hep B and C are spread through blood and sexual con- tact, the hep A virus is usually spread when a person swallows tiny amounts of fecal matter on contaminated objects, including food or drinks prepared by an infected person. A person can give the virus to others up to two weeks before and one week after their symptoms appear. The virus can cause illness anytime from two to seven weeks after exposure. HepA isacontagious liver disease that can be prevented with vaccination. Ar- kansas is one of 10 states to see an outbreak of hep A since August 2016. There are typi- cally less than 10 cases of hepA in the state each year, but since February 2018, there have been over 140 reported cases. More than half of those people infected have been hospitalized, and one person has died. Cen- tered in Northeast Arkansas, the majority of cases are in Greene County. There have also been cases in Clay, Craighead, Indepen- dence, Lawrence, Lee, Mississippi, Monroe, and Randolph counties. This outbreak ap- pears to be spread from person to person in people’s social networks. It is critical for healthcare providers to be aware of the rise in hep A cases, and for patients to get vaccinated. Symptoms to watch for include fever, fatigue, loss of appetite, nausea, vomiting, stomach pain, dark urine, clay-colored bowel movements, joint pain, or jaundice (yellowing of the skin or eyes). Symptoms are typically more severe in older adults and people who have other infections or chronic diseases like hep B or C, HIV/AIDS, or diabe- tes. Risk factors that may increase a person’s chance of hepA infection include illegal drug use, having close contact with someone who has hepA, experiencing homelessness or be- ing shelter insecure, and international travel. There are no treatments for hep A, but it can be prevented with a safe and effective vaccine. The vaccine is given in two doses at least six months apart. Ninety-nine percent of people who receive both doses will be protected against the hep A virus, but even