BOLLINGER COUNTY HEPATITIS A OUTBREAK UNRELATED TO ANY SINGLE EVENT, OFFICIAL SAYS

The eight confirmed cases of hepatitis A in Bollinger County are the result of person-to-person transmission and aren't associated with a restaurant or single event, a state health official said."These are linked cases with the virus being passed from person to person," said Sue Tippon, communicable-disease coordinator for the Missouri Department of Health's Southeast District headquartered in Poplar Bluff.

Tippon was in Marble Hill Thursday helping the Bollinger County Health Department assess who might have come in contact with the eight people who have the viral liver disease. The first case in that county was confirmed in early September, the next about a month later, and more continued to occur in October. Three people tested positive for the virus in the past week.

The confirmed cases are scattered in and around Marble Hill. Some are members of the same family and some are school-age children, Tippon said.

Some people who may have been exposed to the virus through contact with carriers are in Cape Girardeau County, said Jane Wernsman, assistant director of the Cape Girardeau Country Health Department. "We are providing immune globulin to those contacts and providing them educational information on prevention," she said.

Immune globulin can prevent an exposed person from developing hepatitis A if given within two weeks of exposure.

Contacts are uncovered through interviews with disease carriers about who they may have prepared food or drink for or in some other way may have passed the disease to, Tippon said. The Bollinger County Health Department is contacting people who may have been exposed to the hepatitis virus so they can be given immune globulin."Keeping the disease from spreading hinges on getting contacts named and getting them in for immune globulin within the specified time period," Tippon said.

Tippon said preventing outbreaks of hepatitis A also depends on getting people to understand that the best way to prevent its spread is thorough hand-washing.

Hepatitis A is highly contagious and is spread through the fecal-oral route, says the Missouri Department of Health. Hepatitis A is usually spread from person to person by putting something in the mouth that has been contaminated with the stool of a person who has the disease. If hands are not washed thoroughly after using the toilet, the virus can be carried on the infected person's hands and spread by direct contact or by eating or drinking foods or beverages that were handled by the infected individual."People should always wash their hands after going to the bathroom, before eating and before preparing food," Tippon said.

Wernsman said there is a vaccine that will protect against hepatitis A, and it is available at the Cape Girardeau Country Health Department. The county charges full price for the vaccine since it is not supplied by the state. Charge is $25 per dose for adults and $20 for those under 19 . Two doses are required six months apart."The vaccine is an excellent way to prevent contracting hepatitis A," Wernsman said.

This is not the same vaccine as the hepatitis B vaccine now required for Missouri schoolchildren."It's two different viruses transmitted in two different ways," said Wernsman. Hepatitis B is transmitted through blood or body fluids while the A strain is a fecal-oral transmission.

Tippon said health officials hope to keep the present outbreak of hepatitis contained, but she suspects more cases, perhaps even in surrounding counties like Cape Girardeau, may arise."But common sense about personal hygiene like hand-washing can go a long way in preventing the spread of disease," she said.