Hepatitis A has cost state $5 million, killed three

Arkansas’ outbreak of hepatitis A has cost almost $5 million and sickened more than 430 people, including three who died, an epidemiologist with the state Department of Health said Thursday.

In a briefing to the state Board of Health, Michael Cima, the department’s chief epidemiologist, said the outbreak, which started in February 2018, peaked in October of that year and has since plateaued, with three to five people being diagnosed each week.

Of those who have been diagnosed, 59% were illegal drug users and more than half used injection drugs. Ninety-three percent of

those who have been diagnosed were white and 65% were men, he said.

Although homeless people and men who have sex with men are considered to be at high risk of exposure, those groups each made up only 3% of the cases in Arkansas, according to Cima’s presentation.

The largest number of cases have been reported in northeast Arkansas, where the outbreak started. Just over half of those infected have been hospitalized.

The cost estimate of $4.9 million was based on a study by public health officials of a 2013 hepatitis A outbreak in 10 states linked to frozen pomegranate seeds.

That study estimated the average cost in medical care and lost productivity was $13,467 for each person hospitalized with hepatitis A, $2,138 for each patient who wasn’t hospitalized, and $3,221 per patient in personnel costs for each state health department. Arkansas wasn’t among the states affected in that outbreak.

Cima said the actual cost in Arkansas from its current outbreak could be much higher because of inflation since 2013 and the characteristics of the population affected. For instance, 25% of people who have been infected in Arkansas with hepatitis A had also been infected with hepatitis C, a separate disease that also affects the liver.

According to the U.S. Centers for Disease Control and Prevention , 29 other states have also experienced hepatitis A outbreaks since 2016. The disease is typically spread when a person ingests small amounts of fecal matter.

Typical symptoms include fever, fatigue, loss of appetite, nausea, abdominal pain, dark urine, clay-colored bowel movements, joint pain or jaundice.

Although people may feel sick for months, most recover completely and will not have any lasting liver damage, the Health Department said.

In Arkansas, the department has focused on educating and vaccinating people in high-risk groups, such as drug users and homeless people, Cima said. The vaccine has been required since 2014 for Arkansas children in daycare, kindergarten and first grade.

Joel Tumilson, a consultant in the department’s outbreak response section, said people can get the vaccine from their doctor or one of the department’s county offices.

“We just want to encourage as many people as possible that are at risk to get vaccinated,” he said.