Local health officials believe Butler County could be nearing the end of a Hepatitis A outbreak.
After seven years without a single reported case, the county saw 107 people test positive over a three-month period at the end of 2018. The outbreak was primarily linked to drug use, or close contact with someone who had used drugs, officials have said.
There have been no new cases in 2019, according to Whitney Preslar, Butler County Health Department communicable disease nurse and emergency planner.
Health officials typically believe they are nearing the end of an outbreak when two incubation cycles have gone by without a new reported case, said Preslar. Incubation times for Hepatitis A range from two to six weeks, or about 84 days. Butler County is on day 77 without a new diagnosis, Preslar said.
The pace of the outbreak here exceeded that seen in much larger counties, she said.
By comparison, San Diego County, California has 1.3 million people to Butler County’s 43,000. They saw 587 cases over a nearly two-year period.
Preslar attributes vaccinations and education, with the help of media partners, to slowing the spread of the illness here.
“I really believe that’s helped a lot. We’ve been able to vaccinate over 2,200 people,” said Preslar.
The health department scheduled vaccination clinics in a variety of areas in an attempt to reach out to at-risk populations.
Workers found that about 62 percent of those who tested positive also identified as using methamphetamine. Another 5 percent admitted to marijuana use, and 2 percent to heroin or other non-heroin opioids. About 30 percent used two or more of the substances.
“The most common denominator was drug use or someone who was in close personal contact to someone who used drugs, which matches what we’ve seen across the country,” she said.
The spread is caused by contact with surfaces.
“If they’re sharing paraphernalia of any kind and then they’re somehow ingesting it, that’s how it’s being transmitted,” Preslar said. “It’s not like Hepatitis C, where it’s blood to blood. It’s the fecal-oral route that’s taking place.”
The processes and relationships developed during this response will benefit the health department and its efforts going forward, Preslar believes. The health department meets weekly, or more often if necessary, to discuss strategy, epidemiology, who to vaccinate and how to reach people, she said.
A formal announcement of the end of the outbreak may not take place, Preslar said, because new case are also being seen in other areas of Southeast Missouri.