Time to learn more about Hepatitis A. This post is a little long but tells you what you need to know. WWFHC is offering Hep A vaccines on a walk in basis and they are covered by insurance. Southeast Michigan has been rocked by an explosion of hepatitis A (HAV) infections, and the outbreak has officially spread into Huron, Ingham, Lapeer, Livingston, Macomb, Monroe, Oakland, Sanilac, St. Clair, Washtenaw, and Wayne counties. Since August 2016, there’ve been more than 495 cases, a massive increase over previous years in which the Detroit Health Department might record only one or two cases per month. The virus, which attacks the liver, can cause flu-like symptoms, liver damage, and other health issues, and it’s almost always serious. Eighty-four percent of the people who’ve gotten sick have been hospitalized, and 19 have died. To make treating and preventing the illness more complicated, symptoms may not manifest until two to six weeks after exposure. That leaves plenty of time for infected individuals to expose others before they even know that they’re ill. Fortunately, education and vaccination are excellent prevention measures. We know that some people carry additional risk factors for acquiring the disease, including people with a history of substance use, people who are homeless or in transient living, men who have sex with men, incarcerated individuals, food handlers, health care workers, and people with underlying liver disease. The challenge is identifying them. You may be wondering why so many people are getting sick if a safe and effective vaccine exists. The HAV vaccine didn’t become a part of the routine childhood immunization schedule until 1994. As a result, many older adults haven’t been vaccinated, leaving them susceptible to illness. Only 13 percent of Michigan adults have received the HAV vaccine. For people over 40, the vaccination rate drops to less than 5 percent. When you consider that the average age of individuals who’ve contracted HAV since August 2016 is 42 years old, that’s a serious problem. The more people we vaccinate, the more people we can prevent from getting sick. That’s called “herd immunity.” Herd immunity is how we’ve managed to protect most of the world from diseases such as measles, whooping cough, and polio. Once a large percentage of the population is effectively immune to an infection (through vaccination), it makes it harder for that infection to move through a community. Chains of transmission are broken. The probability that someone who is not immune will come into contact with an infectious individual goes way, way down. But beyond increasing vaccination rates, there are also two more important pieces of the prevention puzzle: proper hand hygiene and bathroom cleaning. Hepatitis A enters the body through a fecal-oral transmission route — and it can survive on surfaces for weeks. That makes thoroughly cleaning hands on a regular basis and using bleach to clean bathroom surfaces key components in disrupting transmission and helping prevent infection.