An unexpected number of hepatitis A cases have been reported to the Middlesex-London Health Unit over the last few months, resulting in an outbreak mostly among under-housed or homeless Londoners, and those who inject drugs. Where the Health Unit would only expect to see about three cases of hepatitis A per year, most of them travel-related, there have been 16 non travel-related cases in 2018 so far; 15 since October 1st alone.

As part of its surveillance mandate, and in an effort to better understand and assess the current situation, the Health Unit is working with community agencies and through its Outreach Team to contact those who may be at risk. Health Unit staff has also advised local healthcare providers of the situation, asking them to watch for the signs and symptoms of hepatitis A and to provide hepatitis A vaccine to at risk-patients.

Those at greatest risk include:

• People with chronic liver disease (including hepatitis B and C);
• People who inject drugs, and;
• Men who have sex with men.

One dose of post-exposure hepatitis A vaccine is also publicly-funded for those who are close contacts of laboratory-confirmed cases, including:

• People in the same household as a case;
• Sexual partners, and;
• Individuals who have shared illicit drugs or equipment with a case.

“This situation is a demonstration of the health inequities that exist in our city. The link between most of these cases is that they live on the margins of society, don’t have access to stable housing and struggle with addiction,” says Dr. Alex Summers, Associate Medical Officer of Health with the Middlesex-London Health Unit. “While we can provide vaccines to those who we know are at risk, there’s a much bigger issue that exists just under the surface that needs to be addressed.”

Hepatitis A is disease of public health significance in Ontario, which requires healthcare providers, clinics and hospitals to notify their local public health units when they become aware of cases among their patients. It is likely that the number of local hepatitis A cases may be higher than what has been reported so far.

Media Contact:

Dan Flaherty, Communications Manager, Middlesex-London Health Unit
519-663-5317 ext. 2469 or 519-617-0570 (cell.)

Spokesperson:

Dr. Alex Summers, Associate Medical Officer of Health, Middlesex-London Health Unit