By Sarah Cweik
etroit is trying to fight a hepatitis A outbreak in the face of limited resources and low national vaccine supplies.
Detroit health department director Dr. Joneigh Khaldun talked about the city’s efforts to fight an outbreak of the viral liver disease on a conference call with other local and national health leaders Tuesday.
Michigan is one of a handful of states experiencing hepatitis A outbreaks right now. Michigan’s is one of the largest, with 610 cases and 20 deaths reported since August 2016.
Some of the highest-risk populations, including drug users and people experiencing homelessness, are also some of the hardest to reach. Khaldun says that’s especially true in Detroit, where the homeless population often means people living in transient housing spread out across the city.
So to fight the outbreak, “What we’re doing is trying to reach people where they are,” Khaldun said. That includes working with shelters, health clinics and other partners to screen and vaccinate people. In recent weeks, the health department has also brought on emergency rooms at the city’s four major hospitals to do that work.
The city is also following up with people in close contact with known hepatitis A cases. They can be protected if they receive a vaccine or immunoglobulin within two weeks of exposure.
“For every case that comes through and is associated with a city of Detroit resident, my team immediately responds to identify who those contacts can be, so that we can quickly get that person that post-exposure prophylaxis,” Khaldun sasid.
But that kind of follow-up is a challenge for a department with just three epidemiologists and limited resources. Another challenge: limited national vaccine supplies.
Khaldun says the city is relying on other health agencies to help supplement its efforts. The department is also purchasing more doses from private vendors, but can only get so much at a time. “So we’ve literally been every day purchasing 400 [doses], our max,” she said.