Sara Swanson

Washtenaw Hepatitis A cases part of larger Southeast Michigan outbreak

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from Washtenaw County Public Health

Washtenaw County is one of multiple counties in southeast Michigan with an increased number of hepatitis A cases. No common sources of food, beverages, or drugs have been identified as a potential source of infection. Vaccination and good handwashing can help prevent the spread of illness. Vaccination is strongly recommended for anyone at increased risk of illness or who works in certain occupations where infection could spread to large numbers of people.

“We have an extremely effective hepatitis A vaccine; however, most adults haven’t received it,” says Jessie Kimbrough Marshall, MD, MPH, medical director with Washtenaw County Public Health. “We are working to offer it as quickly and as easily as possible, especially to those groups we’ve prioritized as being at increased risk of infection or transmission of the hepatitis A virus.”

Who should get vaccinated?

Washtenaw County Public Health is prioritizing hepatitis A vaccination for:

  • People who use injection or non-injection illegal drugs
  • People currently homeless or in transient living
  • Men who have sex with men
  • People incarcerated in correctional facilities
  • People who work with the higher risk groups listed above, such as health care providers and first responders
  • People who are in close contact, care for, or live with someone who has the hepatitis A virus
  • People with underlying liver disease (including hepatitis B, hepatitis C, or alcoholic liver disease) or clotting factor disorders
  • People who prepare food for others, such as food service employees and restaurant workers

Where to get vaccinated

If you have health insurance, contact your health care provider or pharmacy for the hepatitis A vaccine. Washtenaw County Public Health can provide hepatitis A vaccination to anyone without health insurance, with Medicaid, or who cannot get it elsewhere. Please call 734-544-6700 to schedule an appointment.

Washtenaw County Public Health is also offering additional opportunities for hepatitis A vaccination without an appointment:

  • Thursday, Dec. 7: Walk in at Salem Township Hall at 9600 Six Mile Road, Salem 48175 from 2-6pm
  • Monday, Dec. 11: Walk in at Washtenaw County Public Health at 555 Towner Street, Ypsilanti 48198 from 8:30am-4pm
  • Tuesday, Dec. 19: Walk in at Northfield Township Public Safety Building at 8350 Main Street, Whitmore Lake 48189 from 6-9pm

Check for future community walk in clinic dates.

The hepatitis A vaccine is free at Washtenaw County Public Health if you:

  • Have Medicaid
  • Are uninsured
  • Have Blue Cross Blue Shield or Blue Care Network insurance and present your insurance card and identification

If you have any other private insurance, the vaccine cost is $64 and a receipt will be provided for you to request reimbursement.

Hepatitis A

Hepatitis A is caused by the hepatitis A virus, and it can cause damage to the liver and other health problems. Hepatitis A can range from a mild illness lasting a few weeks to a serious illness lasting several months. The current outbreak is causing high rates of hospitalization (84 percent of cases).

Symptoms of hepatitis A include fatigue, poor appetite, stomach pain or tenderness, nausea or vomiting, dark urine, and yellowing of the skin (jaundice). Most children less than six years do not experience symptoms. Symptoms typically appear two to six weeks after exposure. Individuals with symptoms should call their provider or seek care.

How is it spread?

Washtenaw County is considered part of a larger, ongoing outbreak of hepatitis A in Southeast Michigan. Hepatitis A appears to be spreading through direct person-to-person contact or illicit drug use. Those with history of injection and non-injection drug use, homelessness or transient housing, and incarceration are thought to be at greatest risk.

The virus is found in the feces (poop) of people with hepatitis A. Most infections result from contact with an infected household member or sex partners. Sometimes, infection results from food or drink that is contaminated with the virus. It is not spread through coughs or sneezes. Anyone who has hepatitis A can spread it to others for 1-2 weeks before symptoms appear.


The best way to prevent hepatitis A is to get vaccinated. One dose is almost 95 percent effective at preventing infection, according to the Centers for Disease Control and Prevention (CDC). The hepatitis A vaccine is now routinely recommended for children at one year of age. Most adults, however, have not been vaccinated against hepatitis A.

Frequent handwashing with soap and warm water after using the bathroom and before handling food can also help prevent the spread of hepatitis A. Appropriately cooking foods can also help prevent infection. Freezing does not kill the virus.

Additional prevention strategies include using your own towels, toothbrushes, and eating utensils; not sharing food, drinks, or cigarettes; and not having sex with someone who has the hepatitis A virus.

Outbreak in Southeast Michigan
As of Nov. 21, there have been 526 cases of hepatitis A diagnosed in Southeast Michigan since Aug. 2016. In Washtenaw County, eight cases have been identified since the outbreak began last year. Seven of those cases have been reported in 2017. Learn more about the Southeast Michigan outbreak

Washtenaw County Public Health promotes health and works to prevent disease and injury in our community. Our mission is to assure, in partnership with the community, the conditions necessary for people to live healthy lives through prevention and protection programs. Visit us at or call 734-544-6700. Public Health is located at 555 Towner Street in Ypsilanti. The Environmental Health Division is located at 705 N. Zeeb Road in Ann Arbor or 734-222-3800.

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