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Oregon shifts hepatitis A prevention efforts

January 2, 2019

BEND, Ore. (AP) — Oregon health officials are working to redirect hepatitis A prevention strategies toward homeless populations following a shift in how outbreaks of the disease occur.

The Bulletin reports the Oregon Health Authority has purchased additional hepatitis A vaccines this year, distributing them to county health departments in areas with large homeless populations.

Previously, hepatitis A outbreaks were mostly linked to international travelers or foodborne outbreaks, with infections occurring mainly in children.

Oregon has documented 20 cases of the disease through November 2018. Four of the cases last year involved people younger than age 40.

The federal Centers for Disease Control and Prevention recorded 1,521 cases of hepatitis A in 2017 from California, Kentucky, Michigan and Utah. Of those, 57 percent had reported drug use, homelessness or both. As a result, the Advisory Committee on Immunization Practices recommended in October adding homelessness to the list of reasons why some should be vaccinated.

Hepatitis A is typically transmitted when someone ingests something that has been contaminated with the feces of an infected person. Symptoms include fever, fatigue, nausea, abdominal pain, dark urine, joint pain and jaundice. Most people recover with limited treatment, but complications can occur especially among people already in poor health.

“The homeless population just seems like the perfect setup for this transmission,” said Dr. Paul Cieslak, medical director for communicable diseases and immunizations at the Oregon Health Authority’s Public Health Division. “You’ve got people living without the benefit of running water and often without toilet or sewage.”

Multnomah County was already routinely screening people at its shelters for tuberculosis, and began offering the additional hepatitis A vaccines provided by the state at the same time.

“It really is a very effective vaccine, so that’s been our main push,” said Lisa Ferguson, who oversees the county’s communicable disease services team. “We’ve been trying to connect with homeless services providers and making sure people out in the field know what to be looking for.”

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Information from: The Bulletin, http://www.bendbulletin.com

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