Important information about ongoing Hepatitis A outbreak in Southeastern Michigan

Please be advised that there is an ongoing outbreak of hepatitis A virus (HAV) infection in southeastern Michigan.

The outbreak includes 200 confirmed cases in Detroit, Macomb, Oakland, St Clair, and Wayne counties identified since June 2016. This is a 10-fold increase over the prior year. There have been 10 associated deaths and numerous hospitalizations.

The Michigan Department of Health and Human Services reports that transmission in this outbreak appears to be related to direct person-to-person spread and illicit drug use. There have not been common food or water sources identified. (Michigan Medicine has reported 17 cases of HAV from June 2016 to date compared to 11 cases the prior year. Two cases are considered part of this outbreak.)

HAV spreads through ingestion of food or water or through oral contact with objects (including hands) contaminated by feces of an HAV-infected individual. Transmission occurs easily among sexual and close household contacts, and persons sharing needles and non-injection drugs.

The incubation period is long (15-50 days) and people often develop symptoms of fever, fatigue, nausea, vomiting, abdominal pain, appetite loss, jaundice, dark urine, pale stools and diarrhea. HAV infection may last a few weeks to several months. Some individuals, especially if co-infected with hepatitis B or C, may develop fulminant liver failure resulting in death.

Here are infection control practices you can take in settings with acute HAV cases:

• Use standard precautions during all patient care activities. Use gloves when having direct contact with feces or contaminated materials.

• Contact precautions-D should be used in the inpatient setting for patients with confirmed or suspected HAV infection.

• Wash hands with soap and running water for at least 15 seconds after providing care for an individual with HAV.  Alcohol-based hand rubs may not be effective against HAV.

• Use bleach or other hospital approved disinfectants that are effective against norovirus to clean the environment or equipment.

• Hepatitis A vaccination is encouraged for unvaccinated healthcare workers with chronic liver disease who may care for patients with HAV infection and others who are concerned about risk of HAV infection.

• Health care workers that care for patients with HAV infection are encouraged to be vaccinated for Hepatitis A.
  • Vaccine is available via Occupational Health Services Monday-Friday 7:00 am – 4:30 pm
  • Please contact occupational health at OccupationalHealth-RN@med.umich.edu if you have questions about vaccination for Michigan Medicine employees.

Please notify the Department of Infection Prevention and Epidemiology if you identify a patient with suspected or confirmed hepatitis A at 936-6355 or by paging 30032.