The Spokane health district is asking the state for almost $1 million to help vaccinate schoolchildren and jail inmates against hepatitis A.
Dr. Kim Thorburn, health officer for the Spokane Regional Health District, said the move could help stem the hepatitis A epidemic and prevent another one from occurring years from now.
Thorburn also announced that the district has run out of immune globulin, the medicine that can prevent the onset of hepatitis A if given within 14 days of exposure.
The hepatitis A epidemic has leveled off in Spokane County at about 50 new cases a month. That high rate could continue for another two years.
“It’s getting to kind of be a broken record,” Thorburn told the health board Thursday.
The health district has spent about $283,000 since November battling hepatitis A, including immune globulin shots, vaccinations, community education and staff time. That doesn’t include January salaries for health district employees.
The district will recoup some of its money from what it charges for the various shots, but it’s unclear how much.
The vaccine costs $84 a person for two shots. Immune globulin doses cost from $19 to $30.
Thorburn asked Gov. Gary Locke for emergency funds on Thursday morning. Most of $750,000 would be used the first year to vaccinate children in grades one through six. The rest of the money would be used for incoming first-graders the second year.
Thorburn said she’d like to find money to continue vaccinating incoming first-graders regularly. The vaccinations would be voluntary.
Although most of the hepatitis A cases have occurred in adults, vaccinating children would prevent a similar outbreak years down the road. Hepatitis A outbreaks usually happen about once every 10 years.
Thorburn is also asking the federal government for money to vaccinate children on Medicaid.
Thorburn asked Locke for about $150,000 to vaccinate jail inmates for the next three to six months.
“Where we can really make an impact is to reach into the drug-using community,” Thorburn told the health board.
As of Thursday, 102 people had tested positive for hepatitis A in the county this year. About two-thirds of those were men, and more than half were between the ages of 19 and 39. Less than 20 percent were intravenous drug users.
Last year, 190 people contracted hepatitis A. About 26 percent were IV drug users.
The virus pops up in clusters, usually in families or in people who share the same lifestyle.
Only five food workers this year have been publicly identified as contracting hepatitis A - four at Players & Spectators, and one at the U-City Rosauers. No other cases of hepatitis A have been traced to the infected food workers.
But every public announcement of another confirmed food-service case sends customers and food workers who may have been exposed rushing for shots of immune globulin.
The district ran through about 800 immune globulin doses this week after a bakery worker at the U-City Rosauers tested positive for hepatitis A.
The county only has about 100 to 200 immune globulin shots left. These will be saved for people exposed to hepatitis A through a family or household member, the most common way hepatitis A is spread.
“The state is out of immune globulin,” Thorburn said. “We’re out of immune globulin.”
It’s a national shortage. The two manufacturers of immune globulin don’t have any more. A third manufacturer that was expecting to start distributing the medicine has run into packaging problems.
Thorburn continued to recommend that restaurants vaccinate their workers against hepatitis A. So far, about 100 businesses have done so.
On Thursday afternoon, the health board approved a resolution supporting the vaccination of every food service worker. The resolution has no power, but sends another message to the food industry to vaccinate their workers.
Hepatitis A causes flu-like symptoms after incubating for two to seven weeks.
This long waiting period makes the virus’ origin difficult to track, because people have to remember where they have dined.
“When you have to look back a month or two, it’s a guessing game,” Thorburn said.
Not everyone who ingests the virus gets sick. People who do get sick suffer occasional nausea, diarrhea, loss of appetite and yellowing of the skin or eyes.
The elderly and people with liver problems can become extremely ill. About 100 people nationwide die every year from hepatitis A.
The virus is spread through fecaloral contact. People should wash their hands thoroughly after using the bathroom and before preparing food.
, DataTimes ILLUSTRATION: Graphic: Hepatitis A from year to year