Hepatitis A outbreak
Cases of hepatitis A continue to be reported in South Australia, with a further 6 cases reported in the last week. There have been a total of 19 notifications in 2017 and 13 since the 1st of November.
In this locally acquired outbreak men who have sex with men appear to be at highest risk, however local transmission to others can be expected.
Hepatitis A is spread through person-to-person transmission, including sexual activity, and through contaminated food and water. The incubation period is 15 to 50 days. Patients frequently experience fever, malaise, anorexia, right upper quadrant pain and nausea, followed a few days later by dark urine and jaundice. Cases are infectious for two weeks before to seven days after the onset of jaundice. There is no specific treatment and most cases fully recover, but ongoing monitoring is required as rarely complications, including fulminant hepatitis, can occur.
Medical practitioners are advised to:
- strongly recommend vaccination to individuals at high risk especially those who may attend sex on premises venues
- be alert for possible cases of hepatitis A in symptomatic individuals, request an urgent hepatitis A IgM (and IgG) for such cases, and consider hospitalisation if unwell
- advise symptomatic patients to avoid preparing food or providing personal care for others, and avoid sex or blood donation until no longer infectious
- initiate contact precautions for suspected or confirmed cases in healthcare facilities
- immediately notify any suspected or confirmed cases to the CDCB on 1300 232 272 as this will assist with public health control measures and will enable rapid post-exposure prophylaxis for close contacts.
Medical practitioners should offer hepatitis A vaccination to individuals at high risk, including:
- men who have sex with men
- people who use intravenous drugs
- people with chronic liver disease
- those with an occupational risk (e.g. sewerage workers, childcare workers)
- travellers to hepatitis A endemic areas and countries with current hepatitis A outbreaks
- Aboriginal and Torres Strait Islander children (included in the National Immunisation Program).
The CDCB will follow up all notified hepatitis A cases and provide vaccine and/or normal human immunoglobulin (NHIG) to contacts exposed during the infectious period where indicated. Vaccine should be given within two weeks of exposure to the case.
For further information see the following: