Florida Declares Hepatitis A Public Health Emergency

August 7, 2019
Drew Boxler

Drug Topics Journal, Drug Topics September 2019, Volume 163, Issue 9

2019 cases greater than five-year trend.

On August 1st, Scott A. Rivkees, MD, Surgeon General and State Health Office for the state of Florida, declared a public health emergency due to the prevalence of Hepatitis A cases in various counties in the state. 

According to Florida’s Hepatitis A Surveillance report released in July 2019, 2,636 cases have been reported in Florida since the start of 2018-2,088 have been reported since the start of 2019. Of those cases, 22% have been linked to other cases, and 24% are co-infected with Hepatitis B or C. Those between 30-39 years of age shoed the highest incidence of disease. 

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Hepatitis A cases steadily increased from January to May of this year, before slowly declining; however, the number of cases still far surpass the five-year trend records.

Since January 2018, 98% of patients that have been diagnosed with Hepatitis A had never received a documented dose of Hepatitis A vaccine, according to the state’s report. As of 2019, 100% of cases have presented in those not having received a documented dose of the vaccine. 

Four of the most common methods of contraction listed in the report are via

  • Sexual Contact: 35%

  • Personal Contact: 28%

  • Household contact: 21%

  • Other/Unknown: 16%

 

Those at risk for contracting hepatitis a include, 

  • The homeless

  • Intravenous drug users

  • Non-intravenous illicit drug users

  • Men who have sex with men 

  • Individuals diagnosed with underlying liver disease

  • Individuals in an emergency room or other acute care setting, after being administered an opioid antagonist such as naloxone 

  • Individuals with clotting factor disorders

  • Individuals working with homeless personas or intravenous drug users outside of health care settings

  • First responders 

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Those suffering from chronic liver disease or are over the age of 60 with a serious underlying medical condition are at the greatest risk.

According to Rivkees’ declaration, healthcare providers should consider screening for Hepatitis A in patients with non-specific symptoms (fever; chills; malaise; decreased appetite; and/or gastrointestinal symptoms such as nausea, vomiting, diarrhea, and abdominal pain) and symptoms such as jaundice, light-colored stools, and dark-colored urine. Screening should be conducted via liver function tests and transaminase levels. 

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