Hepatitis A Contributing Factor in Two Deaths

Hepatitis A Contributing Factor in Two Deaths

Nov 20, 2019

For more information, contact Kelli Hawkins, SRHD Public Information Officer (509) 324-1539 or

SPOKANE, Wash. – This month, two Spokane County adults, both living homeless, died from complications associated with their hepatitis A infection.

As of Tues., Nov. 19, SRHD confirmed a total of 61 cases of hepatitis A in Spokane County. Most cases are occurring in people living homeless and/or who use drugs; the risk to the general population of acquiring hepatitis A is low.

"Unfortunately, the population most at risk of hepatitis A exposure – those who are homeless or who use illicit drugs – are also more likely to have many other health issues," said Dr. Bob Lutz, Spokane Regional Health District’s (SRHD) health officer. “When infected with hepatitis A, the illness is the final straw that results in hospitalization and possibly death.”

SRHD’s disease prevention and response team has coordinated multiple vaccination clinics since June when the outbreak was declared, administering over 1,600 vaccines throughout Spokane County. Vaccines can also be obtained from healthcare providers and pharmacies. 

In addition, the team has conducted education programs and outreach to healthcare providers, community centers, and homeless service providers that teach vulnerable populations the risks of contracting hepatitis A, actions they can take to prevent exposure, and symptoms to watch for. 

In both the national and local outbreaks, a high proportion of cases have had severe infections due to the vulnerable health status of the affected populations. In Spokane, roughly 70 percent of the cases have been hospitalized. Washington State Department of Health (DOH) is monitoring hepatitis A outbreaks throughout the state. Multiple counties in Washington have reported hepatitis A cases, and DOH declared a statewide outbreak in July 2019.  

Hepatitis A virus infects the liver and can cause illness ranging from a mild infection with no symptoms to a more severe illness that can last for months. Hepatitis A virus usually spreads when a person unknowingly ingests the virus after touching an object, food, or drink contaminated with the virus. Unsanitary conditions that result from homelessness, such as a lack of handwashing facilities and bathrooms, as well as drug use, provide the environment for hepatitis A outbreaks to occur.  

“If an infected person doesn’t wash their hands well, especially after toileting, undetectable amounts of the virus can spread from the hands of that person to other objects, surfaces, and foods,” said Dr. Lutz. “Fortunately, it is a vaccine-preventable disease, so it is important that you get vaccinated if you haven’t already.”  

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. Children are routinely vaccinated between their first and second birthdays. Vaccination is recommended for people living homeless, people using injection and non-injection drugs, men who have sex with men, people with chronic liver disease, and anyone who wishes to be immune to hepatitis A.  

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. Anyone with symptoms consistent with hepatitis A should seek medical attention.  

More information and resources on hepatitis A can be found at

The Spokane Regional Health District is a leader and partner in public health by protecting, improving and promoting the health and well-being of all people through evidence-based practices. SRHD is one of 34 local public health agencies serving Washington state’s 39 counties. Visit for comprehensive, updated information about the SRHD and its triumphs in making Spokane a safer and healthier community. Like SRHD on Facebook or follow us on Twitter to receive safety and wellness tips.