SPOKANE, Wash. — On Wednesday, June 5, Spokane Regional Health District (SRHD) confirmed three cases of hepatitis A in Spokane County. One case has been hospitalized; the other two have recovered. While there are many risk factors for hepatitis A, this outbreak is affecting people living homeless. 

Hepatitis A virus causes inflammation of the liver and can cause illness ranging from a mild infection with no symptoms to a more severe illness that can result in liver failure and death. Hepatitis A virus usually spreads when a person unknowingly ingests the virus from touching objects or ingesting food or drinks contaminated with undetectable amounts of stool from an infected person. It can also be spread from close, personal contact with an infected person; this includes caring for an infected person or using drugs with others. Hepatitis A is a vaccine-preventable disease.

An increasing number of hepatitis A outbreaks have been occurring across the country since 2016, especially among people living homeless and people who use drugs (injection and non-injection). Unsanitary conditions that result from homelessness, such as lack of handwashing facilities and bathrooms, as well as drug use, provide the environment for hepatitis A outbreaks to occur. In these outbreaks, a high proportion of cases have had severe infections due to the vulnerable health status of the affected populations.

“Hepatitis A infection is caused by poor hygienic conditions and practices and often affects our most vulnerable populations. Ensuring access to sanitary facilities is essential to limit disease,” said Dr. Bob Lutz, SRHD health officer. “Importantly, it’s entirely preventable by vaccination."

Notifications were sent to healthcare providers containing information about the disease and what to look for in their patients.

Vaccination is an important measure of hepatitis A prevention. The vaccine is safe and nearly 100 percent effective with two doses. It usually consists of two shots given six months apart. Hepatitis A vaccination is recommended for all children at age one year, travelers to countries where hepatitis A is common, people experiencing homelessness, men who have sex with men, people who use or inject drugs, people with chronic or long-term liver disease, people with clotting factor disorders, people with direct contact with others who have hepatitis A, family and caregivers of adoptees from countries where hepatitis A is common, and anyone wishing to obtain immunity.

Adults are more likely to have symptoms than children. If symptoms develop, they usually appear two to seven weeks after infection and can include yellow skin or eyes (jaundice), dark urine and/or pale stools, loss of appetite, fever, diarrhea, fatigue, vomiting, joint pain, and abdominal pain.

SRHD is working with homeless service providers to make vaccine available and to educate high-risk individuals. SRHD recommends vaccine to the risk groups listed above, which can be obtained from healthcare providers and pharmacies. Anyone with symptoms consistent with hepatitis A should seek medical attention.

For more information, go to the health district’s hepatitis A page, located here.