El Paso County has 43 of 52 confirmed cases of hepatitis A in Colorado, the state Health Department confirmed Thursday.
Of those infected with the highly contagious disease in El Paso County, 93% had used illicit drugs, 61% were experiencing homelessness and 23% were incarcerated within six months of their diagnosis, El Paso County Public Health reported. Almost two-thirds were hospitalized with the illness.
“People affected by this outbreak may have less access to health care and greater health risks,” Nicole Comstock, deputy director of the Communicable Disease Branch at the Colorado Department of Public Health and Environment, said in a release.
“Poorer nutrition, living in crowded places such as shelters and jails, limited access to facilities to maintain personal hygiene, and limited access to preventive health care unfortunately make disease spread more likely. ”
The concentration of the disease in the county is on par with a localized outbreak, said Kimberly Pattison, El Paso County Public Health’s program manager for communicable diseases.
“While we do have more cases than other counties, it is about what we expect to see from the epidemiology of a person-to-person spread,” she said, clarifying that the current incidences of hepatitis A in El Paso County have been spread among people in close contact with one another. This is in contrast to regional outbreaks from food contamination, for example.
The outbreak, which has not killed anyone, is spread through through ingested fecal matter — such as from not washing hands after using the restroom.
County and state health officials spent about $63,000 to get ahead of the wave of infections by vaccinating vulnerable populations in late fall and early winter. At the time, only eight people in El Paso County had confirmed cases of the disease, which can cause damage to the liver.
Symptoms can take between two weeks and two months to show up. They include jaundice, fatigue, severe stomach pain, nausea and diarrhea.
Pattison said the county is looking at prevention strategies that were successful in other parts of the country. San Diego and Salt Lake counties, for example, sent nurses on foot to give vaccines to target groups. The disease killed 20 people in San Diego County and three in Utah, according to the state health departments’ websites.
Hepatitis A is usually less severe than another form, hepatitis C, which is most often spread through contact with the blood of an infected person.
The Centers for Disease Control and Prevention says that hepatitis A is rarely fatal and does not result in chronic infection, but hepatitis C becomes a long-term, chronic infection for 70% to 85% of those infected. In 2016, 18,153 U.S. death certificates had hepatitis C recorded as an underlying or contributing cause of death, but that’s a conservative estimate, the CDC says. There also is no vaccine for hepatitis C, although it is treatable with a combination of antiviral drugs.
Hepatitis A rates in the United States have declined by more than 95% since the vaccine became available in 1995, the CDC says.
Utah declared the two-year outbreak over in February. California’s House, known as the State Assembly, unanimously approved a bill Thursday that would make local governments more proactive during outbreaks of communicable diseases.
El Paso County Public Health is working closely with Penrose Hospital, the city and county jails, UCHealth and agencies serving the homeless to ensure easier access to vaccines. Clinics have been set up at the Marion House, Westside Cares and Springs Rescue Mission.