Health Care

Calm down — South Florida’s Hepatitis A problem isn’t as deep as the rest of Florida’s

ABCs of hepatitis: What’s the difference between A, B, C?

Hepatitis is a disease characterized by inflammation of the liver. It comes in many forms, including hepatitis A, B and C. But what do those letter designations mean, and how do they differ from one another?
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Hepatitis is a disease characterized by inflammation of the liver. It comes in many forms, including hepatitis A, B and C. But what do those letter designations mean, and how do they differ from one another?

Numbers starkly tell how, as in the rest of the nation, Hepatitis A is spreading across Florida like humidity.

Those same numbers also say the liver disease’s blob of infection expanding from Central Florida has touched, but not covered, South Florida — yet.

What is Hepatitis A?

The Florida Department of Health says, “Hepatitis A is a contagious liver disease usually spread person to person through objects, food or drink that are contaminated by small amounts of fecal matter from a person with Hepatitis A.”

Symptoms usually start within 28 days, but can take as long as 50 days before showing. The symptoms usually pass within two months. Hepatitis A doesn’t hang around forever. It’s a liver problem, so one of the symptoms is jaundice, a yellowing of the eyes or skin. Nausea and vomiting are common, as well as diarrhea, joint pain, pale poop and dark urine.

How fast is it spreading?

The CDC said in a March health alert, “Multiple states across the country have reported outbreaks of hepatitis A, primarily among people who use drugs and people experiencing homelessness. Since these outbreaks were first identified in 2016, more than 15,000 cases and 8,500 (57%) hospitalizations have been reported. Hospitalization rates have been higher than typically associated with HAV infection. Severe complications have also been reported, sometimes leading to liver transplantation or death; at least 140 deaths have occurred nationwide.”

The Florida Department of Health’s Reportable Disease Frequency Report says there have been 745 confirmed cases of Hepatitis A in the state this year as of April 6. The full year total of 2018: 548. The full year total of 2017: 261. The combined full-year totals of 2014, 2015, 2016 and 2017: 574.

The full year total of 2019 at the current pace: 2,832.

As of Saturday, Miami-Dade (nine), Broward (seven) and Palm Beach (five) each had a number of cases that meet or surpass five, the DOH’s definition of a “high risk” community. But, each remains low compared to many other counties around the state, both on raw numbers of cases and cases per capita.

Just looking at the counties of other major cities, Pinellas County, which has St. Petersburg, also has a state-high 168 Hepatitis A cases. Hillsborough County contains Tampa and 63 cases. Orange County is home of Orlando, Disney World and 74 cases. Only Jacksonville’s Duval County, with two cases, comes in lower than the South Florida counties when considering the state’s big metropolitan areas.

Some of the smaller counties are being inundated. The U.S. Census Bureau’s latest estimate puts Pasco County’s population at 525,643, about one-fifth of Miami-Dade County. Pasco has 152 cases. Marion County, with only 354,353 residents or about 100,00 less than the city of Miami, has 43 cases.

Manatee County’s also less populous than the city of Miami, estimated 2017 poplation of 385,571, but has 11 confirmed Hepatitis A cases.

How does it spread?

The Florida Department of Health’s Hepatitis A handout says, “Hepatitis A virus is in the poop of people who have the virus. If a person with the virus doesn’t wash his or her hands after going to the bathroom, poop can transfer to people, objects, food and drinks.”

That’s why the Department of Health in Miami-Dade issued a notice in February when a restaurant worker at Primo’s Italian Kitchen & Bar, inside the DoubleTree Grand Hotel Biscayne Bay, 1717 N. Bayshore Dr., was diagnosed with Hepatitis A. And it’s why handwashing violations get quickly noted on state inspections of restaurants, supermarkets and other food handlers.

The CDC’s health alert said the most vulnerable groups are the homeless; drug users; men who have sex with men; people who are or were recently incarcerated; people with chronic liver diseases.

What’s the ounce of prevention?

As for day-to-day prevention, proper handwashing (soap, warm water, at least 20 seconds) after using the restroom or many other common handwashing situations. The Department of Health recommends vaccination, two shots taken six months apart. Call your doctor or your county’s Department of Health if you want to get vaccinated.

If you’ve already been vaccinated, you don’t need another shot. If you’ve had Hepatitis A in the past, your body formed antibodies as a future defense against Hepatitis A recurrence.

Since 1989, David J. Neal’s domain at the Miami Herald has expanded to include writing about Panthers (NHL and FIU), Dolphins, old school animation, food safety, fraud, naughty lawyers, bad doctors and all manner of breaking news. He drinks coladas whole. He does not work Indianapolis 500 Race Day.
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