November 21, 2018
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Maine’s handling of Hepatitis A case is welcome change

Steve Griffin | AP
Steve Griffin | AP
Steven Beach, a registered nurse with the Salt Lake County Health Department, administers a Hepatitis A vaccination at a mobile vaccination clinic setup outside at 500 west and 200 south in Salt Lake City, Nov. 16, 2017.

State health officials responded uncharacteristically this week to a reported case of Hepatitis A, publicly announcing that free vaccines will be available to anyone potentially exposed to the infected individual.

In a Monday news release, the Maine Center for Disease Control and Prevention shared some details of the case, including identifying two Portland shelters where the individual stayed earlier this month.

Such disclosure by a health agency attempting to thwart the spread of an infectious liver disease might seem unremarkable, was it not in stark contrast to the state’s handling of a case of the very same illness several years ago.

In 2014, Maine CDC confirmed that a food service worker in Cumberland County may have exposed diners to hepatitis A. Rather than issuing a news release, the agency sent an alert to area hospitals and health care groups urging them to be on the lookout for the disease. The agency refused to disclose key information, including the name of the restaurant where the infected worker was employed, how many people were potentially exposed, and whether those at risk had been identified and informed.

At the time, a Maine CDC spokesman argued that releasing the restaurant’s name would risk identifying the infected worker, a violation of the worker’s privacy. He also said the agency was notified of the worker’s illness after a 14-day post-exposure window during which individuals can be given a vaccine to prevent the disease from taking hold. Because it was too late for that by the time the agency was informed, there was no point in notifying the public, he said.

But even after that two-week window, the vaccine can alleviate symptoms of the disease, and patients can also receive an injection of immune globulin to prevent illness.

Even if it’s too late to get immunized, people potentially exposed to Hepatitis A should be alerted to the risk so they can be diagnosed properly and remain vigilant about personal hygiene to avoid passing the virus to others.

Hepatitis A can be spread through the sharing of food, cups, eating utensils, towels, toothbrushes, cigarettes and syringes, and during sexual contact, according to the Maine CDC. Infection typically occurs when a person ingests fecal matter — even in microscopic amounts — from contact with objects, food or drinks contaminated by the feces of an infected person. The close quarters of a shelter make an ideal breeding ground for the virus.

It’s encouraging to see Maine CDC respond to this new case of Hepatitis A with not only greater transparency but also decisive action to protect the public’s health. The case comes as several other states, including nearby Massachusetts, are battling outbreaks of the disease.

It’s unclear why the agency determined that fuller disclosure in this case, versus the 2014 case, posed an acceptable risk to the infected individual’s privacy. Perhaps because health officials learned of this case more promptly than in 2014, that risk was outweighed by their greater ability to intervene with the vaccination clinics.

Regardless, we hope this step toward improved transparency isn’t Maine CDC’s last.

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