The Metro Public Health Department confirmed 48 cases of hepatitis A have occurred in Nashville since December 2017, including a new acute case infecting an employee at The Back Corner bar in Germantown.

While the risks of contracting hepatitis A from a restaurant worker are low, MPHD issued a public notice "in an abundance of caution, as well as offering free vaccines to any customers that visited The Back Corner from June 28-30.

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Officials said customers have until July 14 to be vaccinated in time to protect against the virus. The free vaccines will be available at any of the three MPHD health centers (see below for addresses), until July 13.

The health department has added additional vaccination outreach events as the hepatitis A outbreak continues to grow.

“We have added at least 10 new vaccination outreach events in the last week,” said Rachel Franklin, Interim Director of Communicable Disease and Emergency Preparedness. “These events are scheduled throughout the month of July and continue to focus on our at-risk populations.”

Four cases have been reported with inmates at the Davidson County Sheriff's Office correctional facilities and two cases have been confirmed among the homeless community.

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Outside of Davidson County, a case has been confirmed with an inmate at the Sumner County Jail.

The Health Department has worked with the Metropolitan Homelessness Commission staff on a hepatitis A vaccine campaign.

The initial campaign began on Monday and continues through July 6. The campaign is in addition to ongoing vaccination efforts at MPHD clinics and Neighborhood Health Clinics. The Metro Health Department added three additional locations in the past week, including Room in the Inn and the Nashville Rescue Mission. Additional vaccine outreach will continue to reach the homeless population.

Friday, July 6: Community Care Fellowship (Ken and Carol’s), 511 S. Eighth St., 9 a.m.-noon Monday, July 9: Nashville Rescue Mission, 639 Lafayette St., 2-6 p.m.
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The Metro Homeless Commission is also reaching out to those living outdoors.

"To get the message out to encampments, and to people living outdoors, where they can get vaccinated", said Judy Tackett, the Director of the Metro Homeless Commission.

“We are early in this response, but based on what we know about hepatitis A and the initial cases, we anticipate the outbreak and response could continue over many months,” said Joanna Shaw-KaiKai, M.D., an infectious disease physician at the Metro Public Health Department, in a news release. “The Health Department’s top objectives in responding are to investigate cases, identify contacts in a timely manner, and increase prevention and vaccination awareness among the community and clinical partners.”

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Hepatitis A is contagious and can spread quickly, especially among at-risk populations,” said Nashville Mayor David Briley in a news release. “As we work to minimize the outbreak, I strongly encourage Nashvillians who are at-risk to get vaccinated at no cost at one of our participating sites. I also want to remind the general population that practicing proper hand-washing is not only good hygiene but a really important way to stay healthy.”

The Health Department continues to offer free hepatitis A vaccine at all three Health Centers to the three risk groups. MPHD received an initial shipment of 1,000 doses of the hepatitis A vaccine from TDH three weeks ago and an additional 750 doses last week. TDH has assured MPHD that more vaccine is available as needed.

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The Metro Public Health Department operates three health centers open 8 a.m. to 4 p.m. Monday through Friday.

East Health Center, 1015 E. Trinity Lane Lentz Health Center, 2500 Charlotte Ave. Woodbine Health Center, 224 Oriel Ave.

An agreement with Neighborhood Health has been established to provide hepatitis A vaccine to those in the three at-risk groups. Neighborhood Health locations and hours of operations are as follows:

Downtown Clinic, 526 Eighth Ave. S., adjacent to the Room in the Inn campus, 8 a.m.-5 p.m. Monday through Friday Madison Clinic, 601 W. Due West Ave., 8 a.m.-10 p.m. Monday through Friday and 8 a.m.-4 p.m. Saturday My House Clinic, 442 Metroplex Dr., Building D, Suite 200, 8 a.m.-5 p.m. Monday through Thursday and 10 a.m. to 7 p.m. Friday.

Walk-ins are welcome. Appointments can be made with Neighborhood Health by calling (615) 227-3000.

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Health Department officials are working closely with the sheriff’s office to investigate and provide protection measures in response to the cases.

Health officials began offering hepatitis A vaccinations on June 9 at Davidson County Sheriff’s Office facilities, reaching inmates and public safety staff. The health department plans to complete the vaccination effort of all facilities on Friday. Going forward, hepatitis A vaccine will be offered when a person in custody enters a facility.

As a result of the confirmed cases, all DCSO inmates will undergo a screening prior to being taken to any scheduled appointments or court dates. If they are found to have any signs or symptoms, they will be isolated and will not leave the facility until they have been cleared by medical staff.

The campaign is in addition to the ongoing vaccination efforts by MPHD and Neighborhood Health.

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Large hepatitis A outbreaks have occurred since early 2017 in several states, including ongoing outbreaks in California, Utah, Kentucky, Indiana and West Virginia.

Hepatitis A general spreads from person-to-person primarily among people who are homeless and people who use illicit drugs.

According to the Centers for Disease Control and Prevention (CDC), those at greatest risk of exposure to hepatitis A in the current outbreaks include:

Illicit drug users (not just injection drug use) Men who have sexual contact with men Individuals experiencing homelessness

Metro Public Health continues to work with the Tennessee Department of Health and CDC on a testing specimen collected from those confirmed as having hepatitis A. The health department received confirmation from the CDC that genotype test results from one of the samples in Nashville matched the strain of hepatitis A found in the recent outbreaks around the country.

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MPHD has hepatitis A vaccine available for children and adults.

The vaccine can also be found at area health care providers in Nashville for those with insurance. Many insurance plans cover the costs of hepatitis A vaccine without a deductible or co-pay if administered by an in-network health care provider.

MPHD issued a health alert two weeks to health care providers in Nashville about the current hepatitis A outbreak, a reminder about the symptoms, and how they should report cases to MPHD.

MPHD has initiated a community awareness campaign focusing on outbreak updates and steps to follow to prevent exposure to hepatitis A. Updates and prevention messaging, such as the importance of hand washing and the use of a vaccine to protect against the virus for those at risk, can be found at www.nashville.gov/Health-Department.

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Hepatitis A is a vaccine-preventable liver disease caused by the hepatitis A virus. Common symptoms include fever, nausea, vomiting, abdominal pain, dark urine, jaundice (yellowing of eyes and skin), and clay-colored stools. The disease can be severe in some people possibly requiring hospitalization. Most recover completely within a few weeks. 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. Hepatitis A can also spread from close personal contact with an infected person such as through sex or taking care of someone who is ill.

The best way to prevent hepatitis A is through vaccination. For more information visit click here.

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