Health officials in Sörmland, Sweden, are taking precautionary measures after a case of Hepatitis A was detected at Nyköping Hospital. The case raises concerns about potential exposure for others who may have used the same restroom facilities as the infected individual. A number of patients are being contacted and offered vaccination against the virus, according to Malin Enarsson, the region’s infectious disease physician.
Understanding Hepatitis A
Hepatitis A is a highly contagious liver disease caused by the hepatitis A virus. The severity of the illness can vary significantly, ranging from a mild, short-lived sickness to a more severe illness lasting months. In some cases, it can lead to liver failure and, rarely, death.
The virus spreads primarily through the fecal-oral route, meaning it’s contracted when someone ingests something – food, water, or even microscopic particles – contaminated with the feces of an infected person. Close personal contact with an infected individual can also lead to transmission.
Recent Outbreak Trends
While Hepatitis A was once relatively common, widespread vaccination efforts implemented in 1996 led to a dramatic decline in cases in the United States. However, outbreaks have re-emerged in recent years, particularly since 2016. According to data from the Centers for Disease Control and Prevention (CDC), more than 44,000 cases have been reported nationwide since then, resulting in over 400 deaths.
The CDC notes that fluctuations in reported cases have occurred over the last two decades, with a notable increase between 2012 and 2013 linked to a multistate outbreak associated with pomegranate arils imported from Turkey. Further increases between 2015 and 2016 were attributed to foodborne outbreaks linked to contaminated imported foods. More recently, outbreaks have been observed among specific populations, including people who use drugs, individuals experiencing homelessness, and men who have sex with men.
Between late 2016 and 2019, substantial increases in Hepatitis A cases were reported. However, from 2019 to 2023, the rate of newly reported cases decreased by 91%. Despite this decline, the number of cases in 2023 (1,648) remained slightly higher than the number reported in 2015 (1,390) before the outbreaks linked to person-to-person transmission began.
Sources of Transmission and Ongoing Concerns
Hepatitis A outbreaks can originate from various sources. Foodborne transmission, as seen in the outbreaks linked to pomegranate arils and, more recently, organic strawberries (in 2022 and 2023), remains a concern. However, person-to-person transmission has become increasingly prevalent, particularly within vulnerable populations.
The CDC highlights that disruptions to healthcare access and public health surveillance during the COVID-19 pandemic may have impacted the detection and reporting of Hepatitis A cases in 2020 and 2021. This underscores the importance of robust surveillance systems and accessible healthcare services in controlling the spread of infectious diseases.
CDC’s Role in Outbreak Response
While state and local health departments typically lead investigations into local Hepatitis A outbreaks, the CDC provides support when requested. This support can include sending “disease detectives” to assist with tracing the source of an outbreak, providing technical assistance, gathering and monitoring case data, and ensuring access to testing and vaccination. The CDC also plays a crucial role in communicating information to healthcare professionals and the public.
Protecting Yourself from Hepatitis A
Vaccination is the most effective way to prevent Hepatitis A infection. The Hepatitis A vaccine is recommended for several groups, including children, travelers to areas where Hepatitis A is common, and individuals at increased risk of infection due to their lifestyle or occupation.
In addition to vaccination, practicing good hygiene is essential. This includes washing hands thoroughly with soap and water after using the restroom, before preparing food, and after contact with potentially contaminated surfaces. Avoiding consumption of potentially contaminated food and water is also crucial.
The situation in Sörmland serves as a reminder of the ongoing risk of Hepatitis A transmission and the importance of proactive public health measures. Individuals concerned about potential exposure should consult with their healthcare provider to discuss vaccination and other preventive strategies.
