Hepatitis A outbreak averted in Highland County Amish community


Nearly 300 vaccinated after case reported

By David Wright - dwright@timesgazette.com



An Amish horse and buggy are shown at the county parking lot behind the Hillsboro Eagles lodge on a sunny Thursday afternoon.

An Amish horse and buggy are shown at the county parking lot behind the Hillsboro Eagles lodge on a sunny Thursday afternoon.


David Wright | The Times-Gazette

A possible outbreak of hepatitis A in a local Amish community may have been averted due to quick work by Highland County Health Department staff and nearly 300 vaccines, according to the county health commissioner.

Health Commissioner Jared Warner said the drama began on March 21 when a local doctor informed the health department that a young Amish boy had hepatitis A.

Warner said the report was particularly concerning because the Amish tend to live life closely with each other.

“Our concern was, as tight knit as their communities are… the opportunity for that disease to spread is really present,” he said.

According to the Centers for Disease Control and Prevention, hepatitis A is a communicable disease of the liver caused by a virus normally transmitted person-to-person through fecal and oral contact or consumption of contaminated food or water.

Symptoms, which usually resolve within two months, include fatigue, low appetite, stomach pain, nausea and jaundice, according to the CDC.

Warner said health department nurses met with the Amish school administrator where the patient attended and discussed the issue.

“(They) said, ‘Hey, here’s what hepatitis A is, here’s how it’s spread, here’s our concerns for what might happen and here’s how you can protect yourself,’” Warner said.

Warner said the vaccine is “very effective,” with just the first course providing more than 95 percent protection from the virus, and the second dose bringing the patient to essentially 100-percent immunity.

“Our initial push to the Amish was ‘Let’s get everyone exposed to this vaccine so they don’t have any issues,’” Warner said.

According to Warner, Amish leadership decided the vaccine could be offered to any family that was interested.

“Within a week of us knowing that we had an Amish boy with hepatitis A, we immunized 274 local people in the Amish community,” said Warner.

Warner declined to comment on the location of the community.

The health commissioner said his department used all of its vaccine supply, and had to travel to Brown, Adams, Clinton, Clermont and Warren counties to borrow vaccines from other health departments.

As of Wednesday, health department staff were still vaccinating Amish families, Warner said.

“This is the way public health should work,” he said.

According to Warner, Ohio is currently experiencing a statewide outbreak of hepatitis A. In 2018, there were 2,000 reported cases and the disease claimed several lives, he said. There were 40 cases last year in Highland County, and while there were no deaths here, there were some hospitalizations, he said.

The health commissioner said the Highland County cases were “just the ones that got bad enough to go to the doctor… There are definitely a lot more hepatitis A cases in the community.”

On a lighter note, Warner said the events of two weeks ago lined up well with the 100th anniversary of public health in Ohio.

The makeshift vaccine clinic in the Amish community “really felt like it could have been something out of the 1900s,” Warner said. “We’ve got horses and buggies pulling up before they walk into the Amish school to get their vaccines.”

Warner said public health has changed a lot since the early 20th century, but “some things, we’re still here doing… Community-based public health and immunization clinics protect the community from disease.”

Warner credited the health department’s nursing staff for preventing the disease’s spread.

“They deserve all the credit for making this happen,” he said. “Hats off to the nursing department.”

The health commissioner also said he was pleased with the way the Amish community responded to the health department’s warnings.

“This was a really positive example of a community that sees a need and mobilizes,” he said. “I think there’s a lesson there for all of us.”

Reach David Wright at 937-402-2570.

An Amish horse and buggy are shown at the county parking lot behind the Hillsboro Eagles lodge on a sunny Thursday afternoon.
https://www.timesgazette.com/wp-content/uploads/sites/33/2019/04/web1_f-amish-buggy.jpgAn Amish horse and buggy are shown at the county parking lot behind the Hillsboro Eagles lodge on a sunny Thursday afternoon. David Wright | The Times-Gazette
Nearly 300 vaccinated after case reported

By David Wright

dwright@timesgazette.com