North Carolina has surpassed 1,000 reported cases of hepatitis A associated with a national outbreak that began in April 2017, according to the state Department of Health and Human Service.
About 63% of the N.C. cases have required hospitalization, and 16 people have died between April 1, 2018, and July 20, 2021.
Of those cases, 495 have been found this year, with 13% of those individuals also infected with hepatitis B, and 48% with hepatitis C.
Individuals with hepatitis A may be at higher risk for severe illness from COVID-19.
Forsyth County, with 62 cases, is ranked fourth among the 59 counties with at least one case over the time period.
Forsyth also has the most cases among the state’s five urban counties, compared with Durham County with nine, Guilford County with 16, Mecklenburg County with 53 and Wake County with 17.
Hepatitis A, a communicable disease, is the inflammation of the liver caused by a ribonucleic virus.
It is usually transmitted person-to-person and spreads when a person unknowingly ingests the virus from objects, food or drinks contaminated by small, undetected amounts of fecal matter from an infected person.
Symptoms can appear abruptly and can include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, diarrhea, clay-colored stools, joint pain and jaundice.
Symptoms can range from a mild illness lasting a few weeks, to a severe illness lasting several months. Most people recover from the disease.
An outbreak of 22 hepatitis A cases was reported for Forsyth in December 2019 with no linked deaths, according to county health director Joshua Swift.
At that time, Swift said the sources of the outbreak were: individuals who inject illegal drugs and other substances and share needles; homeless and transient people; those who have close contact or care for someone with hepatitis A; and men who have sex with other men.
Individuals in high-risk groups can receive a free hepatitis A vaccination at the county health department, 799 N. Highland Ave. in Winston-Salem.
DHHS reported the 14-county region of the Triad and Northwest N.C. with a combined 258 cases.
Davidson County ranked fifth with 61 cases, while Randolph County was sixth with 60.
“The best way to protect yourself against hepatitis A is through vaccination,” said Dr. Erica Wilson, vaccine preventable disease medical director with the state Division of Public Health.
“As always, good hand-washing is key, especially after using the bathroom, changing diapers and before preparing or eating food.
“Using harm-reduction strategies and syringe-service programs is also key in reducing the risk for people who use drugs,” Wilson said.