Although South Carolina is experiencing a hepatitis A outbreak, it is mild compared with the widespread outbreaks in other states, some of which have reported cases in the hundreds and even thousands.
We want to keep it that way, which is why the South Carolina Department of Health and Environmental Control is taking proactive measures to prevent a worse outbreak. It won't be easy. The infection is mostly affecting high-risk groups, some of whose members can be hard to reach, and we'll need the help of those who serve those populations - as well as others - to curb the spread of the virus.
In South Carolina, 91 hepatitis A cases have been reported between Nov. 1, 2018, and May 17, 2019. While that is more than four times the amount we typically see in a year, it is currently not a widespread outbreak that threatens the overall public health.
But we are keeping close watch. Expert staff at DHEC come to work each day intent on protecting the public health through preventing and controlling the spread of disease.
When people work, play and live together, it's inevitable that along with sharing space and time they also, unfortunately, share germs. That can lead to communicable diseases that spread from one person to another, which is why vaccination and good hygiene, including proper hand washing, are important.
While we would prefer to never have an outbreak - or even a case - of diseases such as hepatitis A, mumps or flu, the fact is it's going to happen. When it does, as a state, we must be prepared to respond.
DHEC's role is to conduct disease surveillance and investigations, find exposed contacts/partners and get them tested and provide disease control and prevention services, including vaccination. The public, health care providers, clinical laboratories and many others also play valuable roles in disease control.
South Carolina's current hepatitis A outbreak presents the challenge of trying to reach populations at highest risk of infection, including:
- People who use injection or non-injection drugs;
- People who are homeless;
- People who are or recently were incarcerated; and
- Men who have sex with men.
Hepatitis A is a contagious liver infection transmitted through person-to-person contact with someone who has the infection, contact with personal items the person has contaminated or through eating or drinking food or water contaminated by an infected person. Most people feel sick for several weeks but usually recover completely. Symptoms include nausea, vomiting, diarrhea, stomach pain or yellowing of the eyes and skin.
DHEC has been vaccinating and educating people in high-risk groups to prevent a widespread outbreak that would affect others in the broader public. The agency is offering no-cost vaccines to those at increased risk of exposure at local health departments. Some health care providers, pharmacies and others also provide vaccines at a cost.
Many people in high-risk groups cannot or will not visit DHEC clinics. We must go to them, which is why we welcome relationships with jails and prisons, shelters, soup kitchens and others. We need those who operate such facilities to help convince those who need it to get vaccinated.
This won't be easy. But through effective partnerships, increased vaccination and greater awareness, South Carolina will be well positioned to protect the public health against hepatitis A.
Dr. Bell is state epidemiologist and director of DHEC's Bureau of Communicable Disease Prevention and Control. Learn more about the hepatitis A outbreak in South Carolina at www.scdhec.gov/HepA.
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