County free of hepatitis A cases

While an annual report from the Iowa Department of Public Health indicates a significant increase in cases of hepatitis A in Iowa in 2008, no cases were reported in Plymouth County.

That's according to Deb Steffen, community health manager at Floyd Valley Hospital in Le Mars.

According to the annual Iowa Surveillance of Notifiable and Other Diseases report, Iowa saw a significant increase in the number of hepatitis A cases in 2008, from a low of 13 cases in 2006.

Hepatitis A is a contagious liver disease that results from infection with the hepatitis A virus. It can range from a mild illness lasting a few weeks to a severe illness lasting several months.

There were 109 cases reported last year, a 294 percent increase over the three-year average from 2005-2007.

That number includes a cluster of hepatitis A cases associated with a restaurant worker in southeast Iowa.

The Center for Disease Control (CDC) indicates hepatitis A is usually spread when the hepatitis A virus is taken in by mouth from contact with objects, food, or drinks contaminated by the feces (or stool) of an infected persons.

"The best way to prevent the spread of hepatitis A is to practice good handwashing at all times," said Steffen.

That advice is especially important when working with foods, especially those not cooked, she said.

"Any time you're working with raw fruits and vegetables, or when preparing salads and tearing lettuce, make sure you wash your hands first," Steffen stressed.

"One of the things with hepatitis A is it has a fairly long incubation period," Steffen said.

Hepatitis A was one of the topics at a meeting of health care professionals last week, Steffen said.

Because the virus can be spread through food handlers, there is a potential for many people to be exposed, Steffen said.

With a 60-day time frame for development of the disease, it's necessary to look for when individuals were exposed to the virus to do follow-up care, Steffen said.

Most incubation periods are about 30 days.

Children under age 5, typically do not display symptoms of the disease.

"That means they can pass it on without ever having symptoms," Steffen said. "That's why it's so important to practice good handwashing at all times."

If there is exposure, such as to food contaminated by a food handler, health officials try to identify the dates the person worked and the responsibilities they had.

"If it is caught in time, a vaccine can be given, although there's only a small window of time to do it to be effective," Steffen said.

While not a required immunization in Iowa, the vaccine is available and is being given.

"Eventually we will see a decrease in the virus because they are starting to give hepatitis A vaccine to children," Steffen said.

Children get their first dose of the vaccine at 1 year of age, and then a second dose six months later, according to Steffen.

According to the CDC, rates of hepatitis A in the United States are the lowest they have been in 40 years. The hepatitis A vaccine was introduced in 1995 and health professionals now routinely vaccinate all children, travelers to certain countries and persons at risk for the disease.

By tracking and investigating infectious diseases, the Iowa Department of Public Health (IDPH) is able to identify trends and outbreaks, and take action to protect the public's health, according to IDPH Medical Director Dr. Patricia Quinlisk.

Infectious disease investigation is a great example of what public health does, she added.