VUMC Infection Prevention issues Hepatitis A Alert

Tennessee is currently in the middle of a growing hepatitis A outbreak, centered primarily within Davidson County. The outbreak started in December 2017 and to date there have been 80 cases reported. In light of this outbreak, VUMC Infection Prevention reminds you of some important steps to prevent ongoing spread of this infection. 

All VUMC health care providers should

• Consider hepatitis A in patients with the acute onset of symptoms of hepatitis (yellowing of eyes or skin, fever, nausea/vomiting, dark urine, pale stool, abdominal pain, fatigue and loss of appetite). Those without an obvious alternative diagnosis should have serologic testing for acute viral hepatitis, including hepatitis A IgM.
• Do not test persons without signs of acute hepatitis: false positive IgM results can occur in persons without acute clinical hepatitis illness, especially in the elderly.
• Vaccinate those at higher risk for infection with hepatitis A (see list below).  A single dose of the 2-dose series can provide protection for more than a decade.

a. Persons who use recreational drugs (injection or non-injection)

b. Men who have sex with men

c. Homeless persons

d. Persons with chronic liver disease, including chronic hepatitis B or C

Resources for the public and medical community are available at: https://www.tn.gov/health/cedep/tennessee-hepatitis-a-outbreak.html, including a data collection tool for clinicians when encountering a suspected case. For questions or additional information, please contact the VUMC Infection Prevention at 615-936-0725 or via pager 835-1205.