Vermont is now among 30 states to report a spike in hepatitis A cases since 2016, while New Hampshire is just starting to recover from its own outbreak last year.
The Granite State first saw an increase in cases of people infected by the virus last February, but last month, these cases began to taper off, according to Beth Daly, chief of the Bureau of Infectious Disease Control at the N.H. Department of Health and Human Services.
“By mid-December, we noticed it dropping. It really started to decline rapidly there,” she said. “So far, it’s held consistent, now that we’re only seeing one to three cases or so per week.”
Before the increase, Daly said, the state saw an average of six or seven cases each year.
“It was about that many per week during the outbreak, on average,” she noted.
From November 2018 to Jan. 14 of this year, there were 312 confirmed cases of hepatitis A in New Hampshire, according to data from the department. Of those, 184 people were hospitalized, and two people died.
Four cases were confirmed in Cheshire County. A majority of New Hampshire’s cases were reported in the state’s most populous county, Hillsborough, with 139.
In Vermont, 12 cases were confirmed in 2019, compared to an average of three cases in each of the past five years, a Jan. 16 news release from the Vermont Department of Health states. Most of last year’s cases were reported in southern Vermont, the release notes.
Hepatitis A causes inflammation of the liver, and severe cases can lead to liver failure and death. Most people, though, recover from the illness after several weeks without lasting liver damage, according to New Hampshire’s health department.
The virus spreads when someone ingests a tiny amount of stool from an infected person through food, drink or objects the person has touched. Casual contact does not transmit hepatitis A, the health department says, but thorough hand washing and sanitary practices are important to help prevent it from spreading.
There is no treatment for hepatitis A, but there is a vaccine.
Especially at risk for the virus are people with substance-use disorders; people experiencing homelessness or unstable housing; gay or bisexual men; people who are or were recently incarcerated; and people with chronic liver disease, according to the New Hampshire health department’s website.
“The number one thing we can do to prevent [hepatitis A] is to vaccinate people who are at higher risk,” Daly said.
She added that the vaccine has been recommended for children 12 to 23 months since 1996, but a “significant portion” of the adult population born before then is unvaccinated.
Aside from health care providers and pharmacies, both the New Hampshire and Vermont health departments are working with shelters, syringe service programs, meal sites and other places where people at high risk tend to frequent, to offer free hepatitis A vaccine clinics.
Noting the vast difference in case loads between Vermont and New Hampshire, Daly said the spread of hepatitis A is dependent on the population.
“... it all depends on how people move,” she said. “Once the virus is in your community and being transmitted from person to person, then you can see increases from there.”
New Hampshire, Vermont and Massachusetts are among the 30 states that are experiencing hepatitis A outbreaks and the only states in the Northeast, according to the U.S. Centers for Disease Control and Prevention.
Vermont has also seen an uptick in cases of hepatitis B, which includes many of the same at-risk groups, the release from that state’s health department says. The virus is spread by exposure to infected blood, such as from sharing needles or contact with skin wounds.
Hepatitis B can lead to chronic infection and can cause either mild illness or serious conditions requiring hospitalization.
The Vermont Department of Health’s news release says nine cases of acute hepatitis B virus have been reported, compared to fewer than three cases on average in the previous five years.
Vermont residents are encouraged to contact their health care provider to receive the two- or three-dose hepatitis B vaccine series. The vaccine can also be administered at a local health office to anyone under 65.