Hepatitis in the Community

Hepatitis means inflammation of the liver.  The liver is a vital organ that fights infections, filters the blood and processes nutrients in the body.  Sometimes hepatitis is caused by heavy alcohol consumption, certain medications or toxins.  Most often hepatitis is caused by a virus.  In the United States the most common types of viral hepatitis are hepatitis A, hepatitis B and hepatitis C.  Macomb County has been in the midst of a hepatitis A outbreak since August 2016.

Hepatitis A
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Why Is This Important?

Hepatitis A is a serious, highly contagious liver disease caused by the hepatitis A virus (HAV). HAV is found in the feces (poop) of people with hepatitis A. You can get hepatitis A by eating infected food or water, during sexual intercourse, or just by living with an infected person. Illness can appear 15-50 days after exposure and you can be sick for several weeks. In some cases, people can die. Not all people infected with hepatitis A will get sick, but symptoms can include: 

handwashing
  • jaundice (yellowing of the skin or eyes)
  • stomach or belly pain
  • fatigue or feeling tired
  • nausea or vomiting
  • loss of appetite
  • dark urine
  • pale colored feces (poop)
  • joint pain

Hepatitis A is a vaccine-preventable illness. The hepatitis A vaccine is recommended as a part of the routine childhood vaccination schedule, however most adults have not been vaccinated and may be susceptible to the hepatitis A virus. The best way to reduce the risk of getting hepatitis A is to get vaccinated with two doses of Hepatitis A vaccine. You can also reduce the risk of getting or sharing hepatitis A with some simple steps. Wash your hands after going to the bathroom and before preparing meals for yourself and others. Use your own towels, toothbrushes, and eating utensils. Do not have sex with someone who has HAV infection or share food, drinks, or smokes with other people.

Since August 2016 southeastern Michigan has experienced an outbreak of hepatitis A.  Data and background information on the outbreak in Macomb County can be found below.  For data and background information on the entire southeastern Michigan outbreak and corresponding public health response please visit the MDHHS Hepatitis A Outbreak web page.  The Macomb County Health Department (MCHD) has launched a MCHD Hepatitis A Outbreak webpage for residents and providers to get up to date information.

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What We Do

Working in partnership with MDHHS, MCHD is providing increased hepatitis A, education, vaccination and outreach to at risk populations.  However,any individual not vaccinated against hepatitis A is welcome to visit the Macomb County Health Department Immunization Clinic.  

Who We Serve

MCHD offers all recommended and required vaccinations to residents and non-residents of Macomb County.  During the hepatitis A outbreak, specific populations may be at higher risk of contracting the disease.  MCHD is working with MDHHS and other local health departments to provide targeted outreaches based on data collected during the outbreak.  

How We Impact

Selected performance measures listed below highlight efforts by the staff and partners of MCHD to deliver hepatitis A vaccine to adults at risk during this outbreak. 

PM
2017
4,524
1
611%
PM
Q4 2017
2,832
4
1295%
PM
Q4 2017
11
1
1000%
Hepatitis B
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Why Is This Important?

Hepatitis B virus is transmitted through sharing bloody or body fluids of an infected person.  This typically occurs through sharing drug needles or equipment, sexual contact with an infected person or from an infected mother to her newborn child during delivery.  Occasionally hepatitis B can be spread through close contact when living with someone with hepatitis B.  Most people who get hepatitis B do not have symptoms or illness.  Those who do get symptoms may get: 

  • jaundice (yellowing of skin or eyes)
  • extreme fatigue or tiredness
  • dark urine
  • nausea or vomiting
  • abdominal or stomach pain

Some people who get hepatitis B will develop a chronic, or long term liver infection that raises their risk for cirrhosis of the liver or liver cancer.  


Prevention (not sharing needles, using condoms or avoiding risky sexual behaviors) is always the best option to avoid getting hepatitis B.  Hepatitis B is also preventable with a vaccine.  The CDC recommends all infants get vaccinated with the hepatitis B vaccine at birth and to finish the vaccine series through the normal childhood immunization schedule.  Adults not vaccinated as a child against hepatitis B can also receive the vaccine.  The Macomb County Health Department Immunization Clinic offers hepatitis B vaccinations for adults and children.

Hepatitis C
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Why Is This Important?

Hepatitis C (HCV) is a blood borne viral infection of the liver.  Hepatitis C is primarily transmitted through exposure to infected blood, and most commonly results from the sharing of infected drug needles and other equipment.  It can also be spread from infected mothers to their newborn infant or person to person through sexual contact.  However, these occurrences are much less likely.  Hepatitis C is not spread by coughing, kissing or sneezing.  Most people infected with hepatitis C do not show any symptoms of the illness.  Those who do develop acute hepatitis C may have symptoms that can include fever, fatigue (tiredness), nausea, abdominal pain, dark urine and yellowing of the skin (jaundice.)  Hepatitis C is diagnosed through a blood test.  Acute hepatitis C can lead to chronic infections in the majority of people that remain silent (no symptoms) for years while increasing the risk of liver disease and liver cancer.  


There is no vaccine available for hepatitis C.  Prevention of hepatitis C infection - not sharing needles or equipment used with injectable drugs - is the best option.  Treatment is available for chronic hepatitis C infections with success rates of  90-90% for chronic infections.  However, treatment is extremely expensive ($75,000 - $95,000 per person.)


Over the last 5 years the number of acute hepatitis C infections in all adults and the number of chronic hepatitis Cin people ages 18-29 has increased at an alarming rate.  A concurrent and significant increase in heroin and opiate use has been documented in the community over the same time period.  

I
2017
49
6
1533%
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