Infection Control Consulting Services (ICCS) has been inundated with concerns from healthcare facilities regarding the increasing reports of hepatitis A in the nation. Florida, where ICCS is based, has seen its department of health recently take action in response.
On August 1, Florida's Surgeon General Dr. Scott Rivkees declared a Public Health Emergency to address the increase in hepatitis A cases in the state, which had reached nearly 2,600 reported cases as of July 27. This declaration builds upon a Public Health Advisory issued by the Florida Department of Health in November 2018 and reemphasizes the importance of the vaccination as the best way to prevent hepatitis A infection. Please note that a "public health emergency" is different from a "state of emergency."
At this time, the Centers for Disease Control and Prevention (CDC) has stated that healthcare workers (HCWs) are not perceived to be at high risk for hepatitis A and, therefore, there is no recommendation for HCWs to be vaccinated. However, it is reported that there is no harm in HCWs choosing to receive the vaccine and the decision should be made on an individual basis.
In terms of screening patients, this is an oral/fecal virus and potentially communicable prior to diagnosis. Some patients may present asymptomatic despite carrying the virus whilst others may show signs of mild to severe illness. Organizations should ask themselves whether it is best for their setting to ask patients if they have hepatitis A or are at risk for it.
While ICCS is not downplaying this viral illness, we need to keep in mind that hepatitis A is not a new infection threat and is still not prevalent in the general population. In fact, CDC is not advocating for food service workers to be vaccinated, which goes to show that CDC does not believe hepatitis A to be a significant general public health threat at this time. It is still of the utmost importance that you share information about hepatitis A with your HCWs. As noted, the cause for concern in the healthcare setting surrounds the handling of stool as well as the need to wash hands with soap and water versus using alcohol sanitizer.
To summarize, ICCS stresses the importance of reviewing current information, providing updates for staff and determining what's best for your setting (and, if necessary, developing policies). ICCS advises that HCWs should make their own decisions about obtaining the vaccine. Finally, ICCS continues to stress the importance of hand hygiene when dealing with all patients, regardless of their diagnoses or health status.
If you have any questions about infection prevention practices, policies and processes for your organization, contact ICCS.