The Florida Department of Health (department) today issued a health advisory to inform the public of an increase in hepatitis A cases in Florida and outbreaks reported across the country. The advisory reemphasized the importance of the hepatitis A vaccination.

Since January 2018, 385 cases of hepatitis A virus infection have been reported in Florida. This is more than three times the previous five-year average of 126 cases. Florida’s cases are beginning to mirror national trends as local and state health departments across the country have worked closely with the Centers for Disease Control and Prevention (CDC) to respond to similar outbreaks since March 2017.

Hepatitis A infection is a vaccine-preventable illness. The primary mode of hepatitis A virus transmission in the United States is typically person-to-person through the fecal-oral route. The best way to prevent hepatitis A infection is through vaccination with the hepatitis A vaccine. Additionally, practicing good hand hygiene—including thoroughly washing hands after using the bathroom, changing diapers, and before preparing or eating food—plays an important role in preventing the spread of hepatitis A.

People who should be vaccinated for hepatitis A include:

• All children at age 1 year

• People who are experiencing homelessness

• Users of recreational drugs, whether injected or not

• Men who have sexual encounters with other men

• People with direct contact with others who have hepatitis A

• Travelers to countries where hepatitis A is common

• People with chronic or long-term liver disease, including hepatitis B or hepatitis C

• People with clotting-factor disorders

• Family and caregivers of adoptees from countries where hepatitis A is common

Health care providers are reminded to immediately report all cases of hepatitis A to their local county health department to ensure a prompt public health response to prevent disease among close contacts.

The department will continue to work closely with community partners to raise awareness and promote vaccination by:

• Providing education to persons who report drug use, homelessness and/or men having sex with men, encouraging proper hand hygiene, and offering vaccination.

• Collaborating with community partners associated with Federally Qualified Health Centers, local jails, drug treatment centers, homeless shelters, hospitals, The Florida Department of Children and Families managing entities to increase vaccination access to their clients.

• Providing all high-risk clients who present to department clinics for various services (HIV, STI, TB) with the opportunity to receive hepatitis A vaccination.

• Offering hepatitis A vaccination to all high-risk clients who seek health care services at a syringe services program.

• Providing regular updates and messaging to the medical community

• Continuing to work closely with CDC to ensure we have sufficient vaccine and other resources for an effective response.

What is Hepatitis A?

Hepatitis A is a highly contagious disease that attacks the liver. People infected with hepatitis A are most contagious from two weeks before onset of symptoms to one week afterwards. Not everyone who is infected will have all the symptoms. Symptoms usually start within 28 days of exposure to the virus with a range of 15-50 days. Symptoms can include:

• Jaundice (yellowing skin and whites of eyes)

• Fever

• Diarrhea

• Fatigue/tired

• Loss of appetite

• Nausea and vomiting

• Stomach pain

• Dark-colored urine

• Pale or clay colored stool

How is hepatitis A treated or hepatitis A infection prevented?

• Hepatitis A vaccine is the best method of preventing infection.

• No medicines can cure the disease once symptoms appear. People with hepatitis A symptoms should seek medical care immediately.

• Most people get better over time but may need to be hospitalized.

• Previous infection with hepatitis A provides immunity for the rest of a person’s life.

• People that are exposed to hepatitis A may be given vaccine or immune globulin within 14 days of exposure to prevent infection.

The department, nationally accredited by the Public Health Accreditation Board, works to protect, promote and improve the health of all people in Florida through integrated state, county and community efforts. For more information about the Florida Department of Health please visit www.FloridaHealth.gov

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