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Washington state’s hepatitis A outbreak apparently over after more than two years

The hepatitis A outbreak especially hit the homeless population and those using drugs due to lack of access to things like soap and warm water.

SEATTLE — The Washington Department of Health (DOH) said Thursday that the state’s hepatitis A outbreak, which began in 2019, appears to have ended.

Between April 1, 2019, and Sept. 30, 2021, 465 cases of the disease were reported with 263 hospitalizations and nine deaths.

The outbreak spanned 21 counties, including King County, the state's most populous, which saw 199 hepatitis A cases from January 2019 through last month.

Most of these infections were in the county’s homeless population, according to a report from Public Health - Seattle & King County (PHSKC).

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Hepatitis A is caused by a virus that targets the liver and is spread through infected fecal matter. This is usually passed through food and water that people put in their mouths that can appear to be clean but actually hold traces of human waste harboring the virus.

The best way to prevent hepatitis A is through a two-dose vaccine, which is approved for every person at least 12 months old.

Not everyone infected with hepatitis A gets symptoms, but they can include exhaustion, low appetite, diarrhea, fever, dark urine, pale feces and nausea.

Hepatitis A cases in the country have typically been linked to international travel and contaminated food products, but infections in the state, especially King County, have been linked to person-to-person transmission, with most cases being among the homeless population and drug users.

PHSKC said that these populations are at higher risk because they don’t have easy access to soap and warm water and other hygiene resources.

“The steep decrease in hepatitis A cases and prevention of a larger outbreak locally is an excellent example of what investment in public health can accomplish,” said PHSKC Health Officer Dr. Jeff Duchin. “The hepatitis A outbreak among people living homeless was complex and required multiple, sustained labor-intensive interventions and collaboration with community stakeholders and healthcare system partners.”

When the outbreak began, King County put $375,000 towards vaccination efforts, followed by another $322,000 in 2020. This money helped vaccinate more than 3,500 people against the virus through nearly 1,000 free vaccination clinics at shelters, day centers, villages and other sites serving the homeless and people using drugs.

In other parts of the country, hepatitis A outbreaks have proven much more costly. San Diego County in California, for instance, had to spend more than $12 million to control an outbreak.

To prevent the spread of hepatitis A, wash your hands with warm water and soap and get the vaccine or a combination vaccine to protect against both hepatitis A and B.

Anyone possibly exposed to hepatitis A should contact their health care provider or local health department.