Franklin County Jail Stock

Health Department officials are tracking a statewide outbreak of hepatitis A with 12 cases reported in Franklin County as of Monday morning.

Public Health Supervisor Tony Buel says the countywide cases include seven female and five male residents with ages ranging from their teens to the mid 60s living in Lonedell, St. Clair, Washington, Sullivan and Union.

Although the disease can be contracted in other ways, the majority of the cases in Franklin County and statewide are the result of intravenous drug use. 

Before this year, Franklin County only had one reported case of hepatitis A in the past decade.

“We are tracking all of the cases and we’ve talked to each person,” Buel said. “None of them know exactly where they got it.” 

Buel explained it is hard to track the origin because of the 15- to 50-day incubation period of the virus, which is different in every individual. 

“All of the cases in Franklin County are linked,” Buel said. “Most are linked to drug use. We think we know the first person or persons who contracted it. They believe they contracted it outside of Franklin County somewhere.”

In mid-January, an inmate at the county jail was diagnosed with hepatitis A, which first brought attention to the outbreak in Franklin County, but Buel says it was not the first case they had encountered this year.

At that time, the detention staff transported the inmate to the hospital for an evaluation where health care providers diagnosed the inmate with a case of hepatitis A.

As a precautionary measure the health department was contacted and administered preventive vaccinations to all inmates and personnel who asked for inoculations.  

County Health Department Director Angie Hittson says there is no doubt that public health intervention has prevented additional cases. 

In the coming weeks there will be a commission order on an outbreak response grant.  

“This funding will allow me to increase vaccination coverage and better respond to new cases,” Hittson said. “As always, I have to brag on my staff and tell you that I am so proud of their dedication to public health and the community. They are doing a fantastic job at responding.” 


The statewide hepatitis A outbreak now stands at 266 cases.

About half, or 128 of the people infected with the virus have been hospitalized and one virus-related death has occurred already this year.

Of the 18 counties that have reported cases, Franklin has the sixth most people infected.

Butler County is the highest with 107 reported cases; Stoddard, 36; Scott, 35; Carter, 20; and Dunklin, 14.

All of the other counties on the list have nine or less cases reported.

None of the counties neighboring Franklin have any reported hepatitis cases as of yet. 

Statewide and locally, no common sources of food, beverages, or drugs have been identified as a potential source of the infection. 

Transmission appears to be through direct person-to-person spread. 

Based on current information, persons who use illicit drugs, both injection and non-injection, are at increased risk for hepatitis A during this outbreak.

Franklin County is working closely with the Department of Health and Senior Services (DHSS) to monitor, investigate and respond to all cases and reaching out to contacts and others identified to be at risk to provide education and vaccination.  

The outbreak here is similar to other large outbreaks in metro areas across the country as the primary risk group is individuals who use illicit drugs. 


According to the Centers for Disease Control and Prevention (CDC), about 20 states nationwide are also experiencing similar outbreaks of hepatitis A. 

In Illinois, there have been 45 cases reported ranging in age from 20 to 63.

Several other states also are experiencing similar outbreaks of hepatitis A. 

Thus far there have been no deaths and none of the counties reporting cases are near the St. Louis metropolitan area.

Instead they are clustered in the Chicago and far eastern portion of the state near the Indiana border.


Hepatitis A usually spreads when a person unknowingly ingests the virus from objects, food, or drinks contaminated by small, undetected amounts of stool from an infected person.  

If symptoms occur, they usually appear two to seven weeks after exposure. 

Symptoms usually develop over a period of several days, and may include the yellowing of the skin or whites of the eyes, abdominal pain, nausea or diarrhea. 

Infected persons can transmit hepatitis A one to two weeks before the onset of symptoms.  

The best way to prevent hepatitis A is to get the hepatitis A vaccine. In addition, it is important to protect yourself and others from hepatitis A by thoroughly washing hands after using the bathroom, changing diapers, and before preparing or eating food.