Florida Surgeon General Dr. Scott Rivkees declared a Public Health Emergency to address the increase in Hepatitis A cases in Florida due to the current national outbreak. The declaration builds upon the Public Health Advisory that was issued by the Florida Department of Health (FDOH) on November 18, 2018 and reemphasizes the importance of the Hepatitis A vaccination as the best way to prevent Hepatitis A infection.
To provide information to the public, FDOH has launched a dedicated webpage for Hepatitis A:FloridaHealth.gov/hepa. On this page, visitors can find general information, frequently asked questions, and surveillance data from FDOH, as well as fact sheets for the general public, health care providers, and food service workers. For questions about Hepatitis A, the department has also established a dedicated email address: HepA@flhealth.gov, and information line: 1-844-CALL-DOH (1-844-225-5364), available Monday – Friday, 8 am – 5 pm.
“I am declaring this Public Health Emergency as a proactive step to appropriately alert the public to this serious illness and prevent further spread of Hepatitis A in our state,” said Florida Surgeon General Dr. Scott Rivkees. “The best way to prevent hepatitis A is through vaccination. It is important that we vaccinate as many high-risk individuals as possible in order to achieve herd immunity. I will continue to work with Governor DeSantis and Lieutenant Governor Jeanette Nuñez to take proactive steps to protect the health of Florida’s residents and visitors.”
Pursuant to the Public Health Emergency, the Florida Department of Health (FDOH) will request assistance from the Centers for Disease Control and Prevention (CDC).
This declaration signals to health care providers the importance of screening and vaccination for all individuals considered at high risk for contracting Hepatitis A. While anyone can contract hepatitis A, individuals who are considered by the CDC and FDOH to be high risk include: those who are experiencing homelessness; intravenous and non-intravenous drug users; men who have sex with other men; individuals in an emergency room or other acute care setting, after being administered an opioid antagonist, such as naloxone; individuals working with homeless persons or intravenous drug users outside of health care settings; and first responders.
The declaration also recommends vaccination for individuals or who are at heightened risk for suffering serious complications from contracting hepatitis A. This includes individuals with chronic liver disease, clotting factor disorders, and individuals over 60 years of age with a serious underlying medical condition, as determined by their health care provider, in critically impacted counties.
In Florida, the critically impacted counties are: Brevard, Citrus, Glades, Hernando, Hillsborough, Lake, Liberty, Manatee, Marion, Martin, Okeechobee, Orange, Pasco, Pinellas, Sumter, Taylor, and Volusia. Hepatitis A case counts for 2019 thus far have already surpassed those in 2018. From January 1, 2019, through July 27, 2019, 2,034 hepatitis A cases were reported.
Through this declaration of a Public Health Emergency, the State Surgeon General reminds all individuals to practice good handwashing procedures to prevent further spread of Hepatitis A. All individuals should wash their hands with soap and water for at least 20 seconds, especially after using bathrooms, changing diapers, and before preparing or eating food. Additionally, the declaration emphasized the importance of consistent sanitation practices for public and private facilities with restrooms and showers. The Department of Health has created detailed infographics for sanitation practices designed to prevent the spread of Hepatitis A. These infographics and additional resources are available at FloridaHealth.gov/hepa.
What is a Public Health Emergency Declaration?
A “public health emergency” is not a “state of emergency”. A public health emergency, as defined by Florida Statute 381.00315(1)(c), is a declaration by the State Surgeon General that allows the Department of Health to take actions necessary to protect public health.
What is Hepatitis A?
Hepatitis A is a highly contagious disease that attacks the liver. People infected with hepatitis A are most contagious from two weeks before the onset of symptoms to one week afterward. Not everyone who is infected will have all the symptoms. Symptoms usually start within 28 days of exposure to the virus with a range of 15-50 days. Symptoms can include:
- Jaundice (yellowing skin and whites of eyes)
- Fever
- Diarrhea
- Fatigue/tired
- Loss of appetite
- Nausea and vomiting
- Stomach pain
- Dark-colored urine
- Pale or clay-colored stool
How is Hepatitis A treated or Hepatitis A infection prevented?
Hepatitis A vaccine is the best method of preventing infection.
Practicing good hand hygiene plays an important role in preventing the spread of Hepatitis A.
Use soap and running water and wash for at least 20 seconds, wash hands after changing a diaper or caring for a person, and wash hands before preparing, serving or eating food.
Alcohol-based hand sanitizers do not kill the Hepatitis A virus.
No medicines can cure the disease once symptoms appear. People with Hepatitis A symptoms should seek medical care immediately.
Most people get better over time but may need to be hospitalized.
Previous infection with Hepatitis A provides immunity for the rest of a person’s life.
People that are exposed to Hepatitis A may be given vaccine or immune globulin within 14 days of exposure to prevent infection.
How Hepatitis A is Investigated by the Department of Health
After a case of Hepatitis A has been reported to the FDOH by a health care provider, a county health department (CHD) epidemiologist will interview the individual and collect information regarding the timeline of their previous 50 days, including travel, occupation, drug use, food history and more. The epidemiologist will then identify close contacts of the ill person. If given within 14 days, the Hepatitis A vaccine will help prevent infection among anyone exposed to the virus. As with the national outbreak, the majority of cases of Hepatitis A in Florida are close contacts of persons experiencing homelessness or persons who use or inject drugs. Less than 5% of cases have been identified among food workers. To date, FDOH has not identified a case of hepatitis A transmission from a food worker to a restaurant patron.
