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Three Charlotte-Area Counties See Jump In Hepatitis A Cases

A transmission electron micrograph of a small cluster of the ribonucleic acid (RNA) hepatitis A virus (HAV).
Betty Partin
A transmission electron micrograph of a small cluster of the ribonucleic acid (RNA) hepatitis A virus (HAV).

Health officials in Cabarrus, Gaston and Mecklenburg counties are reporting a recent increase in the number of cases of the vaccine-preventable, highly contagious viral liver infection.

Gaston County has recorded 122 hepatitis A cases so far in 2021, health officials said Thursday afternoon. That's a dramatic spike from 33 total cases reported in the county between 2018 and 2020.

"We’re worried. I mean...our numbers have—what? Quadrupled?" Ellen Wright, communicable disease supervisor for the Gaston County Health Department told reporters.

Wright said she didn't know what caused the recent uptick in cases, though she added that North Carolina has been experiencing an outbreak of hepatitis A since 2018. According to the state’s Department of Health and Human Services, 777 cases and 12 deaths were recorded statewidebetween April 1, 2018 and May 12, 2021. Cases have occurred primarily among people who use injection or non-injection drugs, people experiencing homelessness and men who have sex with men, according to DHHS.

Hepatitis A, according to the Centers for Disease Control and Prevention, is a vaccine-preventable liver infection caused by the hepatitis A virus, which is found in the feces and blood of people who are infected. It is spread through close person-to-person contact, sexual contact and by ingesting contaminated food or water.

Wright said at least two of Gaston County's cases occurred in people whose job duties included food-handling. Neither Wright nor the county's health director, Steve Eaton, would identify the establishments where the infected people were working. Through a county spokesperson, Eaton said the two cases were "unrelated and isolated."

"Through our investigation, we identified no workplace contacts and based on state definitions deemed this very low risk due to appropriate protective measures being taken in the workplace and lack of symptoms at work," Eaton said in a statement emailed by a county spokesperson. "That is why there was not a public notification unlike previous cases/situations where we were concerned about potential public exposures and alerted the public to assist with our contact tracing."

Wright urged residents to get vaccinated against hepatitis A, wash their hands regularly and wash their produce before eating it.

In 2018, Mecklenburg County Public Health spent two weeks vaccinatingsome 2,000 people who had been exposed to hepatitis A at a Hardee’s by an infected employee. So far this year, the agency has logged 14 cases — two more than the 12 total cases in 2020, according to Gibbie Harris, the county’s public health director.

“We are seeing an increase. We’re not seeing what some other counties are seeing,” Harris said Wednesday.

But, she added: "It's happening around us. That's the problem. We're seeing it in other counties so we know that we have a potential issue that we've got to take care of."

In Cabarrus County, health officials recorded 18 hepatitis A cases between January and May of this year compared to just three cases in all of 2019, said Suzanne Knight, the chief clinical director at the county’s health department, Cabarrus Health Alliance. Knight said none of the county’s cases have been associated with a food worker so far.

“Keep washing your hands. I mean washing, washing, washing your hands with soap and warm water,” Knight said. “It’s not only important for COVID but it’s really, really important for hepatitis A, too...especially after using the bathroom.”

Harris said the Mecklenburg County health department is partnering with Charlotte-area homeless shelters this week and next to set up vaccine clinics for both hepatitis A and COVID-19. The Cabarrus Health Alliance has also started hepatitis A vaccine clinics for its residents, according to Knight.

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Updated: June 10, 2021 at 3:21 PM EDT
This story was updated on June 10, 2021 at 3:21 p.m. to include new information presented by Gaston County health officials at a press conference Thursday afternoon.
Claire Donnelly is WFAE's health reporter. She previously worked at NPR member station KGOU in Oklahoma and also interned at WBEZ in Chicago and WAMU in Washington, D.C. She holds a master's degree in journalism from Northwestern University and attended college at the University of Virginia, where she majored in Comparative Literature and Spanish. Claire is originally from Richmond, Virginia. Reach her at cdonnelly@wfae.org or on Twitter @donnellyclairee.