The hepatitis A outbreak in South Carolina is driven by infections among people in high-risk groups, and the S.C. Department of Health and Environmental Control is asking organizations and individuals who serve those populations to help prevent a more serious outbreak that could affect the general public.

DHEC has been working to vaccinate and educate those who are at highest risk of being infected by offering vaccines at health departments, special clinics and other locations. The agency also has established partnerships and encouraged health care providers and others to offer the vaccine.

Between Nov. 1, 2018, and July 19, 2019, there have been 225 hepatitis cases reported in South Carolina. Of those, 56 percent reported drug use, 14 percent were men who have sex with men, 13 percent were or had been incarcerated and 10 percent were homeless making the aforementioned groups high-risk.

A steady rise in hepatitis A cases since November 2018 led to DHEC defining the spread of the virus as an outbreak on May 13, 2019. Given the continuing spread of the disease, it is critical to further intensify efforts to vaccinate people in high-risk groups.

“It is challenging to control hepatitis A outbreaks if those in risk groups don’t seek or have access to immunization services,” said Linda Bell, a physician and state epidemiologist. “Many people in high-risk groups cannot or will not visit DHEC clinics. We must go to them.”

“We need organizations and individuals who offer services to these groups to help convince those who need it most to get vaccinated,” Bell said. “We are asking those who operate shelters, drug treatment programs, soup kitchens, jails and prisons, and others who serve or advocate for people in these groups to partner with us.” Service providers or advocates willing to help are asked to contact a DHEC consultant at 803-898-0861.

Bell said it is also critical for the public to understand the true threat of the outbreak in South Carolina. “A lot of attention has been given to food handlers who have tested positive, but this is not a foodborne outbreak and the concern is not with the restaurants or the food they serve,” Bell said.

The concern is with any individual, some of whom have been food handlers, who become infected with hepatitis A. Food handlers work in a setting in which customers could potentially be exposed to the virus.

However, the risk of hepatitis A virus spreading from an infected employee to customers in a restaurant setting is low. Since the beginning of the outbreak in November 2018, there has been no report of anyone being infected by drinking or eating at a restaurant in South Carolina. Food handlers only represent a small percentage of reported hepatitis A cases in South Carolina. To date, nine food handlers — 4 percent of reported cases — have tested positive for hepatitis A. Most people in the United States get hepatitis A by close person-to-person contact with someone who has the infection; this includes contact with a household member, through sexual contact, or by sharing personal items with an infected person. Hepatitis A is a contagious liver disease. Most people who get hepatitis A feel sick for several weeks, many require hospitalization. Most people usually recover completely and do not have lasting liver damage.

DHEC is currently offering no-cost hepatitis A vaccines to individuals from the aforementioned high-risk groups. Residents can schedule an appointment for a vaccination at their local health department by calling 855-472-3432 or visiting www.scdhec.gov/HealthClinics.