Summit County is experiencing an alarming increase in the number of reported hepatitis A cases, Summit County Public Health officials warned Wednesday.
“Usually we would average only seven per year,” said Tracy Rodriguez, communicable disease supervisor with the health agency. “Now we have 33 cases.”
Since 2016, the Centers for Disease Control and Prevention has been tracking outbreaks in areas of the country, and early last year the Ohio Department of Health declared an outbreak in the state. But cases were concentrated in southwest Ohio and seemed to pass over Summit County.
Until this year.
On Wednesday, Rodriguez’s agency issued a news release detailing the spread of the disease in the county. It advised residents — especially those at a higher risk than the general population — to get a vaccination if they haven't already gotten one.
The agency is also targeting at-risk residents among the area's homeless population and individuals who make use of a needle exchange location on South Arlington Street in Akron.
“I have a nurse who goes out and talks to every single person who comes in,” Rodriguez said.
She said the agency has administered 57 hepatitis A vaccinations at the location since stepping up its efforts.
Hepatitis A, often referred to as hep A, is a liver disease caused by a virus of the same name. It is spread by person-to-person contact and through infected food and water, but it can be prevented by vaccination.
Dr. Blaise Congeni, director of pediatric infectious disease at Akron Children’s Hospital, said children who have the hepatitis A virus often show no signs of the disease. About 70 percent of the time, he said, they are asymptomatic. But they can still infect others.
“The big message with hepatitis A is that children usually transmit the virus to adults,” Congeni said. “It’s a much more significant illness in adults.”
In 1995, a hepatitis A vaccine was added to the standard regimen given to children. Congeni said the vaccine — Twinrix protects against both hepatitis A and hepatitis B — is highly effective with even one of the two recommended doses.
Since the Centers for Disease Control and Prevention first identified outbreaks of hepatitis A in 2016, more than 15,000 cases, 8,500 (57 percent of cases) hospitalizations and 140 deaths have been reported.
Symptoms of the disease include yellow skin or eyes, fatigue, loss of appetite, abdominal pain, dark urine and/or gray-colored stools, joint pain, nausea, vomiting and fever.
Data compiled Wednesday by Summit County Public Health also show a dramatic shift among cases connected to the use of illicit drugs.
Last year, about 9 percent of the reported cases were connected to drug abuse. Through April 10 of this year, 74 percent of the examined cases show a connection.
Dr. Thomas File, chair of the infectious disease division at Summa Health and professor of internal medicine at Northeast Ohio Medical University, said the rise in hepatitis A cases linked to drug abuse has its roots in the opioid epidemic that hit Ohio and Summit County particularly hard.
“This is a reflection of the negative impact of the opioid crisis and epidemic,” File said. “Hepatitis A is classically not transmitted” by tainted needles, he said, but drug abusers tend to be exposed to other risks such as tainted food and water. As such, File said, “They have a higher risk of developing hepatitis A.”
That’s one reason Summit County Public Health is concentrating efforts on vaccinating individuals at the needle exchange site. The agency has also reached out beyond the South Arlington Street location.
“We’ve gone out to where we know there’s homeless,” Rodriguez said. The agency plans to be present at Community of Christ Church on Grant Street on April 27 from 4-6 p.m. to offer hepatitis A vaccinations. It also has sent personnel to other events and locations where at-risk individuals congregate.
The Ohio Department of Health declared a statewide outbreak in early 2018. Since Jan. 5 of this year, the department has reported 2,077 hepatitis A cases with 1,280 hospitalizations and seven deaths. Portage County has reported nine cases in the same time frame, and Wayne and Medina counties have reported two cases each. Stark County has reported none.
Beacon Journal staff writer Rick Armon contributed to this report.