Health officials want area residents to know about and take action against a growing disease outbreak.

More hepatitis A cases have been confirmed in the Mount Rogers Health District than any other health region in the commonwealth.

Of the 134 hepatitis A cases reported statewide between Jan. 1 and Aug. 15, 23 affected individuals live in the Mount Rogers district, which includes Smyth, Wythe, Bland, Carroll, Grayson and Washington counties, and the cities of Bristol and Galax.

The Cumberland Plateau, which serves Buchanan, Dickenson, Russell and Tazewell counties, has been home to 19 cases. Only two other districts report double-digit caseloads of the viral infection that causes inflammation of the liver: the Peninsula District (Newport News, Williamsburg) with 14 and the Three Rivers District (Northern Neck and Middle Peninsula) with 11.

The Virginia Department of Health (VDH) declared Virginia to be an “outbreak state” in April. The high percentage of cases in Southwest Virginia is due to proximity, said Dr. Karen Shelton, director of the Mount Rogers Health District.

The disease outbreak began in Kentucky, she said, then spread to West Virginia and Tennessee.

Hepatitis A, Shelton explained, is easier to transmit than hepatitis B and C, which are blood-borne. Hepatitis A is spread in much the same way as gastrointestinal viruses – through food and drink or by close personal contact with someone who is infected with the virus. According to the VHD, Hepatitis A “can be found in the feces (stool) of infected people and their feces can contaminate surfaces, objects, food, or water. People get sick by swallowing the contaminated food or water or by putting their hands in their mouths after touching contaminated surfaces or objects. The virus can also spread from person to person through sexual activities and sharing contaminated needles.”

Hepatitis A can be a serious and even deadly illness.

Some people don’t develop symptoms and experience only mild effects. Others, however, may experience symptoms, including tiredness, decreased appetite, fever and nausea. Some people may also develop vomiting or abdominal pain, clay-colored stool, or dark urine. Jaundice (a yellowing of the skin and the whites of the eyes) might occur.

Statewide, Shelton noted, that of the people sick enough to visit the ER, 50 percent have been hospitalized.

Symptoms, according to the VDH, usually appear within four weeks after exposure. Shelton noted that an infected person is contagious two weeks before symptoms appear.

The virus, she said, can linger on surfaces for weeks.

While acute Hepatitis A is often thought of as a disease that most affects global travelers, the homeless, illegal drug users or prisoners, Shelton said everyone is at risk. She noted that once they’re infected, food handlers can easily spread the virus.

To combat the disease, Shelton said, the health department is conducting an intense campaign with restaurants to teach workers how to prevent the spread of disease and ensure food safety.

With the number of cases, Shelton said, the general population should take the outbreak seriously and consider getting the Hepatitis A vaccine.

In recent years, she said, many pediatricians have been vaccinating children, but most adults are not protected.

“I highly recommend the vaccine,” the health director said, noting that it is 95 percent effective. With a booster dose at six months, the vaccine offers lifetime protection.

The vaccine will offer protection to individuals within two weeks of exposure to Hepatitis A.

The vaccine is available at local health departments and at many physician offices and pharmacies.

Shelton also said, “Hand washing is key” after individuals use the restroom and before they prepare food.

“Hand washing, hand washing, hand washing -- with soap and water,” she emphasized.

The Mount Rogers District typically experiences one or two acute Hepatitis A each year.

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