Howell County Health Department

For the first time since 2010, Hepatitis A is confirmed in Howell County, not just in one patient, but in 45 since December 2018, says Howell County Health Department Administrator Chris Gilliam.

According to the Missouri Department of Health and Senior Services (DHSS), preliminary data calculated as of July 30 show only Franklin and Butler counties in Missouri have reported higher numbers of cases, with Franklin County tallying 58 and Butler County, 109. Those numbers are provisional and subject to change.

By contrast, in 2010, the last time a case was identified in Howell County, 30 cases were reported statewide.

“Officials at the Howell County Health Department, in partnership with the Missouri Department of Health and Senior Services, feel that all appropriate control measures are being conducted,” said Gilliam. “Although the Hepatitis A outbreak is concerning, there is not a cause for alarm due largely to the interventions being implemented by public health.”

Quelling rumors that restaurants are associated with the outbreak, Gilliam said that does not appear to be the case in Howell County.

“Food establishments have not been linked as the source of infection in current Hepatitis A cases,” he said. “Currently efforts are being undertaken by the Howell County Health Department to work with area food vendors and restaurants to exclude employees who present with symptoms associated with Hepatitis A.”

In addition, he said, only one case has been confirmed in connection with local homeless shelters.

“The Howell County Health Department continues to work with area shelters by providing Hepatitis A vaccinations as well as education in an effort to protect against the spread of disease.”



Hepatitis A is a highly contagious infection that affects the liver, said Gilliam, adding that most people recover completely, but in rare cases, it can cause liver failure and death. Other forms of Hepatitis, including Hepatitis B and C, also affect the liver but are spread differently.

Hepatitis A, he said, comes from ingesting fecal matter and its spread can be prevented by thorough handwashing after using the restroom or changing diapers and before preparing food.

Hepatitis B, against which most infants are recommended by the Centers for Disease Control and Prevention to be vaccinated at birth, is spread by blood and bodily fluids, and Hepatitis C is spread from blood to blood.

Symptoms of Hepatitis A include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay colored stools, joint pain and jaundice, or yellowing of the skin and eyes.

Those most at risk for contracting the disease are drug users regardless of needle usage, anyone who has been detained or works in a jail or detention center, recipients of substance abuse counseling or treatment, individuals with unstable housing or who are homeless, patients receiving drug substitution or attending drug court, men who have sex with other men and anyone with close contact to someone who has been diagnosed with Hepatitis A, explained Gilliam.

“Students returning to school are not at an increased risk for Hepatitis A,” he added. No mass vaccination clinics have been scheduled, based on information the local health department has gathered, however vaccinations are available for those considered at risk.

The Hepatitis A vaccine is approved for children age 1 through adulthood. The vaccine for Hepatitis B does not offer any protection against Hepatitis A, said Gilliam. The Hepatitis A immunization consists of two doses separated by six months, and according to Gilliam, offers more than 90% protection after the first dose.

A limited number is available to those who are not considered to be at high risk for contracting Hepatitis A.

Anyone with questions is encouraged to call the health department at 256-7078.

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