The Massachusetts Department of Public Health issued an advisory last Friday cautioning municipal health agents about a rise in hepatitis B outbreaks in our region.
The DPH says the increased transmission is associated with injection drug use in Southeastern Massachusetts and is related to the ongoing substance abuse epidemic.
“The MDPH has observed an increase in the number of cases of acute hepatitis B virus (HBV) infection reported in the Bristol County area,” states the advisory. “The MDPH asks healthcare providers to increase vigilance for acute HBV infection in patients who report current or recent injection drug use.”
Kathleen Downey, public health nurse for the Town of Marion, said that although the uptick in cases in Bristol County is of a concern to her given the close proximity to Tri-Town, what also concerns her is the similar uptick in cases on the South Coast, which should be a concern to the residents she serves in Marion.
“Whether we are willing to acknowledge it or not, there is a fair number of people in our community who are suffering intravenous drug addiction,” said Downey over the phone on Tuesday, January 16.
It was just last week, Downey said, that she was informing the Board of Health about a rise in hepatitis B infection in the area. Three days later, she received the advisory from the state.
There were 32 confirmed acute HBV cases in 2017, a 78% increase over the annual average. Twenty-two of the cases were individuals known to inject drugs and/or had tested positive for the hepatitis C virus. Most of the individuals are in their 30s and 40s and were likely not to have been vaccinated as children, the advisory states.
“That’s definitely an uptick in the number of cases,” Downey said. “Whenever we see an incident of some particular disease increasing, you want to find a way to resolve it, especially when we’ve worked so hard to eradicate it.”
Babies are now routinely vaccinated against hepatitis B, but those who are roughly age 25 and older may be at risk for the disease because they have not yet been vaccinated. The DPH advised health care providers to provide the vaccination to patients who may be susceptible to transmission of the virus, especially to patients that have reported injection drug abuse.
Hepatitis B is a viral infection that attacks the liver, increasing the chances of developing liver failure, liver cancer, or cirrhosis of the liver. It is spread through contact with blood or other bodily fluids of an infected person. The virus can live up to seven days outside the body and is commonly spread through the sharing of needles.
During the acute infection phase, most people experience no symptoms at all. Some people do experience acute illness for weeks, with symptoms such as jaundice, dark urine, extreme fatigue, vomiting, and pain in the abdomen.
About 5% of adults infected will develop a chronic infection, while 20-30% of those suffering chronic infection will develop cirrhosis or liver cancer.
The World Health Organization says transmission can also occur through sexual contact, dental and surgical procedures, tattooing, or the use of razors that have been exposed to blood of a hepatitis B-infected person.
According to the WHO, hepatitis B is a global health problem, with an estimated 256 million people living with the hepatitis B infection.
The vaccine was first introduced in 1984 and is believed to be 95% effective in preventing infection.
“The bottom line is people just need to be aware,” Downey said.
For any questions of concerns about hepatitis B or intravenous drug abuse, contact your local Board of Health or you may contact Public Health Nurse Kathleen Downey by calling 508-748-3507.
By Jean Perry