Massachusetts health officials announced Monday that one person has died and 64 others have recently acquired acute hepatitis A infection in an outbreak affecting the state's homeless population as well as those battling substance abuse.
The state Department of Health has issued a public health alert and is encouraging local health departments to work with agencies providing services to people who are homeless and those dealing with substance abuse to educate them about the health risks and to offer the vaccine.
The department has scheduled a call for Wednesday with local health officials.
Of the 65 hepatitis cases, nearly half are located in Boston, with others in the southeast and metro Boston areas.
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In early August, the Department of Public Health and the Boston Public Health Commission issued a clinical advisory when it became apparent that there was ongoing transmission occurring among residents experiencing homelessness and dealing with substance abuse.
Most of those affected in Massachusetts and elsewhere also have evidence of hepatitis C, a blood-borne infection highly associated with injection drug use, making their illness more severe.
"We have seen a spike in cases of hepatitis A, with outbreaks being reported in at least 10 other states in similar populations, constituting thousands of cases nationwide," Public Health Commissioner Monica Bharel said. "As part of our statewide response here in Massachusetts, we are reaching out to all local health departments to encourage and assist their efforts to provide education and vaccinations for people at risk."
Hepatitis A is transmitted primarily through fecal-oral contact that can be associated with living in unsanitary conditions and poor hygiene. Symptoms include fever, fatigue, loss of appetite, stomach pain, nausea, diarrhea, and jaundice, grey stools, and dark urine.
"There may be misconceptions about the different types of hepatitis," said Dr. Catherine Brown, state epidemiologist. "Hepatitis A infection can be prevented through vaccination and one dose of vaccine can provide substantial protection. It can also be prevented through proper hand washing, especially after using the toilet and before eating. There is no specific treatment for hepatitis A infection; most otherwise healthy people recover on their own."
For more information about hepatitis A, click here.