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US communities reach
out to homeless as
as
liver disease surges
By MIKE STOBBE AP AP Medical Writer
WORCESTER
Mass Mass (AP) — This industrial city in in central Massachusetts has had many nicknames through the the the years including “the Heart of the the the the Common- wealth” and “Wormtown ” ” Among them
was this less-known medical moniker: “Hepatitisville ” Worcester has endured several outbreaks of of the liver-battering disease including one that sidelined 90 members of of a a a a a a college football team in in 1969 Given its its history and its its size it it it it wasn’t surprising Worcester was was hard hit when recent hepatitis A outbreaks in in in in the state started sickening — — and and killing — — home- less people and and illicit drug users The surge was part of a a a a a a a a a a national rise in the the viral disease Outbreaks have popped up in in in 17 states in in in the the the last two years leading U S health officials to recommend for the the first time that a a a a a a a routine vaccination be given specifically to to homeless people Some places have struggled to to respond watching deaths and illnesses mount But this time Worcester is is a a a a a a a a bright spot City officials planned for for an an an outbreak before it it it happened and and used a a a a a a a a a a coalition o of agencies and and community groups to meet homeless people where they live The relative success in Worcester has limited the illnesses and and shown how how long- term outreach to homeless people and and drug users can pay dividends in in times of crisis The outbreak which first flared in in in September seems to be be petering out out at 58 confirmed cases “I think we had a a a a a a great response Ev- erybody came together ” said Worcester’s health commissioner Dr Matilde Castiel THE DISEASE
When Victoria McMahon fell ill last fall she initially shrugged it it it it off believing it it it it was the the kind o of heroin withdrawal symptoms she’d weathered before But her her eyes were yellow (“like a a a a snake’s”) and her her skin the color of a a a a a a a a ba- nana she recently recalled A A doctor told the 26-year-old she she was was in grave danger She She had hepatitis A A She She was was stunned “You usually hear about it in third world countries and places where there isn’t good hygiene ” she said There are different different types of hepatitis — — known by different different letters — — that vary in how how how common they they they are how how how sick they they they make people and how how how they’re spread In the the the the United States hepatitis A is is less common than some other forms of of the the the disease It tends to be thought of of of as
as
a a a a a kind of of food food poisoning sometimes spread through tainted food food food or or spurred by an an infected infected food-handler with poor hygiene Most infected infected adults suffer fatigue low ap- petite stomach pain nausea and jaundice — symptoms that usually end within two months of infection It also has been thought to be be on on on a a a a a a a a a path to to vanishing Hepatitis A rates have fallen by more than 95 percent since a a a a a a a a vaccine
first became available in in in 1995 Aiding that decline is a a a a a a a a a a a a a 13-year-old CDC recommen- dation that doctors vaccinate all all all 1-year- olds meaning basically all all all cases these days are unvaccinated adults As recently as
as
2015 there were fewer than 1 1 400 cases reported in in the the the U S ac- cording to the the Centers for Disease Control and Prevention Then came the the recent outbreaks throughout the the country It started with one in San Diego that killed 20 people and hospitalized about 400 Officials eventually declared an an emergency and sent nurses out with homeless service workers to visit people living in in in parks and ravines Last year there were more than 11 000 hepatitis A illnesses reported nationally — including about 40 deaths It’s been worst in in in in in Appalachia with more than 3 000 000 cases reported last year in in in in Kentucky and 2 000 000 in in in in West Virginia Hepatitis A outbreaks can burn them- selves out out after a a a a a a a a a a large number of people are are exposed to to the the virus but vaccinations are are considered a a a a a a a a crucial way to to halt them
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