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Hepatitis A Outbreak in Southeast Michigan and Growing Opioid Crisis

MDHHS issues Annual Viral Hepatitis Surveillance Report, urges vigilance
in light of hepatitis A outbreak in Southeast Michigan and growing opioid crisis 

LANSING, Mich. – The Michigan Department of Health and Human Services today issued its annual Viral Hepatitis Surveillance Report on hepatitis B and C, as local health officials and MDHHS continue to investigate an outbreak of hepatitis A cases in Southeast Michigan. As vaccines exist to protect against hepatitis A and B, and hepatitis C is linked to the growing opioid crisis, Michigan is urging residents to learn the facts, particularly steps residents should take to protect themselves.

The annual report shows that morbidity and mortality associated with viral hepatitis infections are on the rise.  Viral hepatitis-related hospitalizations, liver cancer incidence, liver transplants, and viral hepatitis deaths have all increased over the last decade.  These trends are largely driven by the impact of chronic HCV infection.

Hepatitis A Virus (HAV) is transmitted person-to-person through the ingestion of fecal matter containing the virus.  HAV can spread through food or water if proper hand hygiene is not used by food handlers, and close contact such as household or sexual contacts.  Importantly, HAV is a vaccine preventable disease and MDHHS encourages HAV vaccination of at-risk individuals, particularly in light of the recent HAV outbreak in Southeast Michigan. From August 2016 through August 1, 2017, there have been 223 reported cases in the city of Detroit, Macomb, Oakland, St. Clair, and Wayne counties.      

Hepatitis B Virus (HBV) is a pathogen transmitted person-to-person via contaminated blood.  In 2016, 1,284 new HBV diagnoses were reported in Michigan. As HBV is also vaccine preventable, incidence has declined in recent years largely due to increased HBV vaccination coverage.  However, there remains a significant burden of HBV in developing countries and immigrant populations.  Though they make up only 3 percent of the Michigan population, Asians represent nearly 20 percent of the new HBV diagnoses reported in 2016.

Hepatitis C Virus (HCV) is also a blood-borne pathogen, but there is no vaccine for HCV.  In 2016, 11,883 new HCV infections were reported, making it one of the most common reportable diseases in Michigan.  During the same year, 2,060 of those new HCV infections occurred in persons aged 18-29 years old, compared to just 78 diagnoses in this age group in 2001.  The epidemic of HCV in the young adult population is linked to the growing opioid crisis.  History of injecting drugs, the primary risk factor for HCV transmission, was reported by 84 percent of those new HCV diagnoses.  Statewide increases in HCV were correlated with a rise in heroin overdose deaths and heroin substance abuse treatment admissions over this same time frame.  Battling the opioid epidemic continues to be a major focus of Michigan’s Opioid Taskforce and Stop Overdose Campaign.

HCV treatments, which can cure over 90 percent of persons with HCV, are effective at reducing the risk of death from cirrhosis and liver cancer.  Unfortunately, many patients have not been treated and there remains a significant proportion of undiagnosed HCV infection across the state.

Surveillance for viral hepatitis infections is important for identifying trends in rates of infection, characterizing at-risk groups, evaluating prevention programs, and identifying outbreaks.

For more information about viral hepatitis, visit www.michigan.gov/hepatitis or www.cdc.gov/hepatitis.  Additional viral hepatitis statistics can be found in MDHHS’s Annual Viral Hepatitis Surveillance Report.

For important information about immunizations, visit Michigan’s I Vaccinate Campaign.


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