Lon­don health unit warns of hepati­tis A spike

Sentinel-Review (Woodstock) - - FRONT PAGE - JEN­NIFER BIEMAN

The Lon­don-area health unit is warn­ing about an out­break of a highly con­ta­gious liver dis­ease among the home­less and il­lic­it­drug-us­ing pop­u­la­tion in the city af­ter a more than five-fold in­crease in re­ported cases.

The Mid­dle­sex-Lon­don Health Unit typ­i­cally sees about three hepati­tis A cases each year that are mostly travel-re­lated. But so far this year, the agency has en­coun­tered 16 non-travel-re­lated hepati­tis A in­fec­tions, all but one of them re­ported since Oct. 1

“This sit­u­a­tion is a demon­stra­tion of the health in­equities that ex­ist in our city,” Dr. Alex Sum­mers, the area’s as­so­ciate med­i­cal of­fi­cer of health, said Tues­day. “The link be­tween most of these cases is that they( those in­fected) live on the mar­gins of so­ci­ety, don’t have ac­cess to sta­ble hous­ing and strug­gle with ad­dic­tion,” he said in a state­ment. Savvy trav­ellers know that the viruses for both hepati­tis A and B are com­monly present in much of the de­vel­op­ing world, with the World Health Or­ga­ni­za­tion (WHO) not­ing that hepati­tis A is mainly spread through food or water con­tam­i­nated by an in­fected per­son’s fe­ces. Epi­demics can erupt “ex­plo­sively,” the WHO says.

Though such out­breaks are rarer in North Amer­ica, the health unit says the ac­tual num­ber of cases here may be higher than what’s been re­ported.

“While we can pro­vide vac­cines to those who we know are at risk, there’s a much big­ger is­sue that ex­ists just un­der the sur­face that needs to be ad­dressed,” Sum­mers said. Hepati­tis A is a liver in­fec­tion that can be pre­vented by vac­cines. The virus can be trans­mit­ted through con­tam­i­nated food and water or by close con­tact with an in­fected per­son. Trav­ellers to coun­tries where san­i­ta­tion and food prepa­ra­tion may not be up to stan­dards are urged to get vac­ci­nated be­fore they go.

Many peo­ple who con­tract hepati­tis A may not feel ill. For those who do, fa­tigue, nau­sea, ab­dom­i­nal pain and fever are among the main symp­toms.

In some peo­ple, the in­fec­tion can lead to se­vere ill­ness that may last sev­eral months.

Peo­ple with chronic liver dis­eases, in­clud­ing hepati­tis B and C, in­tra­venous drug users and men who have sex with men are at high­est risk for the virus, the health unit says.

A post-ex­po­sure hepati­tis A vac­cine is also avail­able for peo­ple who share a home with an in­fected per­son, are in a sex­ual re­la­tion­ship with an in­fected per­son or have shared il­le­gal drugs or drug para­pher­na­lia with an in­fected per­son.

Pub­lic Health On­tario has been mon­i­tor­ing an out­break of the ill­ness across the prov­ince that was first de­tected in 2017. The cases have been trans­mit­ted mainly by per­son-to-per­son con­tact, the pro­vin­cial or­ga­ni­za­tion says.

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