Tennessee is the latest US state to report an outbreak of hepatitis A with around 14 cases confirmed in Nashville since December.
Over the last two years, a resurgence of the infectious disease has hit at least eight states including Michigan, Kentucky, Utah and West Virginia.
The Metro Public Health Department (MPHD) began issuing free vaccines for the potentially deadly virus at three public health centers on Tuesday.
However, the city likely does not have enough vaccine doses to meet demand, meaning that the outbreak could spread and put more of Nashville’s residents at risk.
Tennessee is the latest US state to report an outbreak of hepatitis A with around 14 cases confirmed in Nashville since December
According to an agency email obtained by The Tennessean, the local health department currently has about 1,150 doses, which covers less than five percent of the at-risk population, as many as 600,000 people.
Risk factors include anyone who has not been vaccinated, use of recreational drugs, living in a household with an infected person and being a sexual partner of someone and affected person, according to the World Health Organization.
Brian Todd, spokesman for the MPHD, said the agency had some doses on hand and received an additional 1,000 doses from the Tennessee Department of Health on Thursday.
‘We still have a good supply of vaccine, and additional vaccine is available as needed,’ he said in a statement.
Hepatitis A is a virus that attacks the body through liver inflammation. It is highly contagious and is typically spread through sexual contact, needle sharing, or by consuming food that has been contaminated by someone infected with the virus.
Symptoms include fever, nausea, vomiting, abdominal pain and dark urine.
Nashville has seen an average of two cases of the disease per year over the past few years, according to a news release from the health department.
Now, seven-times that many have been confirmed in a matter of months.
Those who are at risk of developing hepatitis A include drug users, men who have sex with men and homeless individuals.
The virus can be spread through contact with objects, food, or drinks contaminated by the feces of a person who has the virus.
This extends to sexual activity or contact with fingers that have the virus on it.
Public health officials in Michigan, Indiana and California highlighted these factors while Arizona’s outbreak was largely restricted to homeless individuals who sought services at the same shelter.
Vaccine administrators in Nashville will be prioritizing drug users and men who have had male sexual partners because 12 of the 14 known cases appear to be connected with these groups.
Occasionally, a common source of exposure can be found. One example was in Utah where as many as 2,000 people were exposed to the virus at a 7-Eleven after an employee diagnosed with the virus came to work during their infectious period.
Nashville Metro Health director Dr Bill Paul sent out a mass email on Thursday saying he expected that the outbreak would only increase in size.
‘We anticipate that this outbreak will get bigger and require a vigorous response over many months by many organizations,’ Dr Paul wrote.
Since January 2018, the Centers for Disease Control and Prevention has issued hepatitis A alerts in Arkansas, California, Indiana, Kentucky, Michigan, Ohio, Utah and West Virginia.
The agency says the best way to prevent the spread of infection is to practice good personal hygiene, such as washing your hands, and to receive the hepatitis A vaccine, which is given as two shots that are six months apart.
In the US, there are three FDA approved hepatitis A vaccines: Vaqta, Havrix, and Twinrix.