State health officials seek budget boost to contain the hepatitis A outbreak

Florida's surgeon general
Florida's new surgeon general. Credit: University of Florida

Florida health officials are asking for $15 million in the new state budget to contain an outbreak of hepatitis A and other emerging diseases, including measles and Zika.

The liver disease hepatitis A has infected 3,221 Floridians this year through Dec. 7, according to the state Department of Health. It is nearly six times the number of residents – 548 – who were infected last year.

Florida has the second highest death toll in the nation from hepatitis A, with 56 deaths since June 2018, according to the federal Centers for Disease Control and Prevention. Kentucky has the highest hepatitis A death total, with 61 deaths since August 2017, the federal data show.

“It’s going to take a while before this is fully contained,” Florida Surgeon General Scott Rivkees told the Senate Appropriations Subcommittee on Health and Human Services on Wednesday. “But I’m really proud of the activities of our county health departments and our partners. In our very highly impacted counties, we are seeing the numbers go down really substantially.”

The hepatitis A outbreak has been particularly acute this year in Central Florida, with Pasco County at the top with 409 cases through Dec. 7, the state health data show. Other counties with major outbreaks include Pinellas (377), Volusia (291), Orange (191), Hillsborough (163), Lake (154), and Marion (149).

The state Health Department is asking for $7.2 million in the 2020-21 state budget to purchase nearly 235,000 doses of a hepatitis A vaccine. It is also requesting $940,000 for local health department supplies related to the vaccinations.

In its budget request, the agency noted that about 80 percent of the residents infected with hepatitis A require hospital care, which can cost about $77,000 per case. And those costs are often covered by public funding through health-care programs such as Medicaid and Medicare.

But it only costs about $50 for public health agencies to provide a vaccine.

“If the department was better resourced to prevent those 1,750-3,500 additional cases by vaccinating at-risk people before they become exposed, we could conservatively prevent over $107 million to $215 million in [hepatitis A]-associated healthcare charges,” the agency said.

Through early December, nearly 293,000 residents have been vaccinated, both through the county health departments and other medical providers, the state data show.

The state Health Department is seeking an additional $7 million in operating costs in response to not only the hepatitis A outbreak but also continuing efforts to monitor and contain a host of other diseases, such as Ebola, yellow fever, measles, dengue, Zika, chikungunya and the flu.

As the nation’s third-largest state, with a large contingent of both domestic and foreign visitors, the state is particularly vulnerable to the emerging disease threats.

Sen. Gayle Harrell, a Martin County Republican, questioned Rivkees about restaurant workers being infected with hepatitis A, particularly in the Orlando area.

“At the present time we are not aware of any situations where there has been transmission from a food service worker to a patron in the state of Florida,” Rivkees said.

If a food worker is infected, Rivkees said, both the Department of Health and the state Department of Business and Professional Regulation, which oversees the restaurant industry, investigate to determine whether proper safety precautions are being taken.

If the investigation determines that those safety practices haven’t been followed, the state will notify the restaurant patrons about the infected worker and advise them to be vaccinated, Rivkees said. He said that has happened in a little more than 20 cases.

Hepatitis A can be contracted from person-to-person contact or indirectly if someone ingests fecal matter infected with the virus, state health officials say.

In addition to vaccines, the disease can be prevented through diligent hand-washing, particularly after using the bathroom, changing diapers, or before preparing food, health officials say.

The Florida Phoenix previously reported on the hepatitis outbreak in this story.