Hepatitis A, B and C

Prompt notification to the local health department facilitates case investigation and prophylaxis of contacts. Post-exposure prophylaxis is recommended within 14 days of exposure. Suspected and confirmed cases should be reported to the Macomb County Health Department.

Lab Testing and Reporting:  Confirmation of hepatitis A infection is important.  Recommended testing includes Hepatitis A IgM and liver enzymes are also helpful.

Hepatitis A outbreak

Macomb County, as well as other Michigan communities, experienced an outbreak of hepatitis A infections in August 2016. Over 200 hepatitis A cases were reported in the county, and over 900 cases in Michigan (as of September 25, 2019). Macomb County typically sees about six cases a year.

A common source of the outbreak has not been identified. The Health Department worked with many community partners to combat the spread of the virus.  Please review the information below to see how everyone can help take small actions that will help control the spread of hepatitis A infection. 

Help prevent the spread of hepatitis A with proper cleaning, disinfection and handwashing.

Hepatitis A outbreak information on case data is provided by the Michigan Department of Health and Human Services.

Outbreak Resources

More hepatitis A education and outreach materials (e.g., letters, brochure, poster, flyer and infographics) are available for the following groups and others:

• At-Risk Populations
• Food Service Workers
• First Responders
• Healthcare Providers
• Community Clinics

Joint Press Release from Local Health Officers - December 11, 2017

The hepatitis A vaccine is effective at preventing infection. Vaccination is recommended for:

• Persons who are homeless.
• Persons who are incarcerated.
• Persons who use injection and non-injection illegal drugs.
• Persons who work with the three high-risk populations listed above.
• Persons who have had close contact (e.g., household, caregiver, or sexual) with someone who has hepatitis A.
• Men who have sex with men.
• Food handlers
• Healthcare workers
• Travelers to countries with high or medium rates of HAV.
• Persons with chronic liver disease, such as cirrhosis, hepatitis B, or hepatitis C.
• Persons with clotting factor disorders.
• Any person who is concerned about HAV exposure and wants to be immune.

• Healthcare provider
• Macomb County Health Department has multiple office locations offering vaccination: Clinic days, times and locations.

If you (or someone you know) do not have health insurance, you may qualify for free or low-cost vaccines. Talk with the health department to find out if you qualify.

For more information about getting the vaccine at the Macomb County Health Department, please call the Immunization Clinic at 586-469-5372.

When you contract HBV, you might experience flu-like symptoms. You could also develop jaundice, which causes your skin and eyes to turn yellow, along with dark urine and pale stools. However, some individuals infected with HBV don't show any symptoms at all.

However, others might feel tired, lose their appetite, have stomach pain, or feel like throwing up. For many, it is a short-term illness that goes away, but for some, it becomes a long-lasting problem that can lead to severe health issues like liver disease or liver cancer. So, getting vaccinated is a good way to protect yourself from this virus.

The most effective method for avoiding hepatitis B is by getting the vaccine. The vaccine is recommended for all adults between 18 and 59 years old, and it's available for any adult who wants it. Additionally, every adult aged 18 and above should undergo screening at least once during their life.

General Information 

• Common Hepatitis B Questions and Answers
• Hepatitis B Vaccination

Who gets hepatitis C?

Persons at highest risk for HCV infection include:

• persons who ever injected illegal drugs, including those who injected once or a few times many years ago,
• people who had blood transfusions, blood products or organ donations before June 1992, when sensitive tests for HCV were introduced for blood screening, and
• persons who received clotting factors made before 1987.

Other persons at risk for hepatitis C include:

• long-term kidney dialysis patients,
• healthcare workers after exposures (i.e., needle stick or splashes to the eye) to the blood of an infected person while on the job,
• infants born to HCV-infected mothers,
• people with high-risk sexual behavior, multiple partners and sexually transmitted infections,
• people who snort cocaine using shared equipment, and
• people who have shared toothbrushes, razors and other personal items with a family member who is HCV-infected.

How is the virus spread?

Like hepatitis B virus, hepatitis C virus is spread when blood or body fluids of an infected person enters the body of a person who is not infected, such as through sharing needles or "works" when shooting drugs or occupational needle stick injury. The risk of sexual transmission has not been thoroughly studied but appears to be low in long-term, monogamous relationships. There is no evidence that the hepatitis C virus can be transmitted by casual contact such as hugging or shaking hands, through foods, by sharing eating utensils or drinking glasses, or by coughing or sneezing. Hepatitis C is not spread by breastfeeding.

What are the symptoms and consequences of infection?

Approximately 20 percent of persons exposed to the virus develop symptoms which may include jaundice (yellowing of the skin and whites of the eyes), fatigue, dark-colored urine, stomach pain, loss of appetite and nausea. After the initial infection, 15-25 percent will recover and 75-85 percent will become chronically infected (lifelong infection). Approximately 70 percent of persons chronically infected will develop liver disease, sometimes decades after initial infection.

How soon do symptoms occur?

Symptoms may occur from two weeks to six months after exposure but usually within six to nine weeks.

Persons with acute hepatitis C virus infection are generally contagious from one or more weeks before the onset of symptoms. The contagious period is indefinite in chronically infected persons. All persons who test positive should be considered to be potentially contagious.

Drugs (anti-viral) are licensed for treatment of persons with chronic hepatitis C. It is important to know that the decision to treat hepatitis C is complex and is best made by a physician experienced in treating the disease.

Since the early 1990s, blood donation centers throughout the U.S. have routinely used a blood donor screening test for hepatitis C. Widespread use of this test has significantly reduced the number of post-transfusion hepatitis C infections.

People who are infected with hepatitis C should not drink alcohol. They should talk with their doctor before taking any new medications, including over-the-counter and herbal medications. They should also talk with their doctor about getting the hepatitis A and hepatitis B vaccines.

People who have had hepatitis C should remain aware that their blood and possibly other body fluids are potentially infective.

• Do not shoot drugs; if you shoot drugs, stop and get into a treatment program; if you can't stop, never share needles, syringes, water or "works", and get vaccinated against hepatitis A and B.
• Do not share personal care items that might have blood on them (razors, toothbrushes).
• If you are a health care or public safety worker, always follow routine barrier precautions and safely handle needles and other sharps; get vaccinated against hepatitis B.
• Consider the risks if you are thinking about getting a tattoo or body piercing. You might get infected if the tools have someone else's blood on them or if the artist or piercer does not follow good health practices.
• HCV can be spread by sex, but this is rare. If you are having sex with more than one steady sex partner, use latex condoms correctly and every time to prevent the spread of sexually transmitted diseases. You should also get vaccinated against hepatitis B.
• If you are infected with HCV, do not donate blood, organs or tissue.

Is there a vaccine for hepatitis C?

Currently, a hepatitis C vaccine is not available.

Resources for People Living with Hepatitis C

Transportation

• Need transportation to or from a doctor’s visit? Macomb Community Action provides transportation services. Visit 1 of our 3 locations to fill out an application to see if you qualify for services.

• Uber or Lyft are also good alternatives to get to and from the doctor’s. (smart phone required)
•  SMART bus offers reliable transportation services. Find your route today!

Medicaid Enrollment - Need health care coverage?

• Start by seeing if you qualify for Medicare, Medicaid or to select a Michigan private health insurance plan through healthcare.gov.
• Medicaid: Can’t afford a private plan? Apply for Medicaid today and check out additional resources provided by Michigan Department of Health and Human Services.
• Beneficiary Help Line: 1-800-642-3195 or beneficiarysupport@michigan.gov 

Peer Support

Living with hepatitis C is challenging, but Help4Hep is great resource to help find the support you may need. Check out the variety of resources they have to offer.

Resources for Hepatitis C Testing

Where can I get tested?

• You can get tested for hepatitis C from your primary care provider by simply asking to be tested for hepatitis C.
• There are other facilities that offer testing if you don’t have a primary care provider:
  • MyCare Health Centers
  • The Macomb County Health Department: STI/HIV Program.

Resources for Preventing the Spread of Hepatitis C

Preventing the spread of disease/viruses is needed to keep our loved ones and community healthy. There are many resources available to help prevent the spread of bloodborne diseases including hepatitis C.

Syringe Service Programs (SSPs) offer excellent services and resources to those who are struggling with substance abuse disorders.

• Exchange dirty or used equipment for clean and sterile equipment to ensure you are safe from spreading or contracting the disease, and that you are injecting safely.  Some sites offer counseling and resources if you or a loved one is looking for a new start.
• Find a site close to you!

Rehabilitation services

• Some health insurances require sobriety before prescribing treatment to individuals with hepatitis C.  Find a rehabilitation service that fits your needs.
• MyCare Health Centers also offer alcohol and opioid treatment programs. Contact the MAT Care Coordinator at 586-783-2222 or visit their website for more information.