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A hepatitis A outbreak that spanned nearly two years, infecting 281 people and killing three, has ended with no new cases in the past 100 days, according to the Utah Department of Health.

SALT LAKE CITY — A hepatitis A outbreak that spanned nearly two years, infecting 281 people and killing three, has ended with no new cases in the past 100 days, according to the Utah Department of Health.

"The majority of Utah's outbreak-associated cases occurred in people who live along the Wasatch Front and reported illicit substance use and/or were experiencing homelessness," said health department epidemiologist Bree Barbeau.

The local outbreak began May 8, 2017, and the last outbreak-related case of hepatitis A was reported on Oct. 26.

While more cases may still be reported, the health department is focusing on prevention efforts and vaccinating high-risk populations.

Public and private funding was secured through the health department to cover the cost of vaccinating people who could not pay and were not insured, Barbeau said. A hepatitis A vaccine is typically $25 per dose. Anyone already infected with the illness, she said, does not need to be vaccinated, as the disease confers lifelong immunity once contracted.

Vaccination efforts, Barbeau said, definitely helped curtail the outbreak in Utah.

Hepatitis A is a contagious liver disease that begins with infection from the hepatitis A virus. It is transferred by close contact with someone who has the disease, eating shellfish harvested from sewage-contaminated water, and through sexual contact with someone infected with hepatitis A.

Before 2017, the majority of outbreaks of hepatitis A in United States were related to imported food items, the national Centers for Disease Control and Prevention reports.

Symptoms can range from mild to severe and typically appear two to six weeks after exposure, including jaundice or yellowing of the skin and eyes, fatigue, nausea and vomiting, abdominal pain, clay-colored stools, loss of appetite and low-grade fever.

A series of vaccines for hepatitis A, which has been part of the routine childhood immunization recommendations in Utah since 2002, helps to keep the majority of the population from contracting the illness. The shots, given in two to three doses, is nearly 100 percent effective, said Dr. Dagmar Vitek, medical director at the Salt Lake County Health Department.

Further efforts to avoid illness include proper hygiene, he said.

"To reduce your risk of catching or spreading the hepatitis A virus, always wash your hands thoroughly after using the restroom, before preparing or eating food, and after coming in contact with fecal material," Vitek said, adding that the vaccine is available through health care providers, local public health department clinics and at various pharmacies.

The hepatitis A vaccine, the health department reports, is safe and effective for anyone who wants to cut their risk of contracting the virus.

Even one dose, Barbeau said, is up to 94 percent effective.

The CDC reports that similar outbreaks of hepatitis A, specifically among homeless populations, have occurred throughout the states since early 2017, including in the midwest, Maine, Florida and in Utah, California and New Mexico.

Utahns ages 22 to 90 were infected with the virus, and more than half of them were men. The local health department reports that 152 were hospitalized with the condition and many also had other viral infections at the time they were tested.

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Three people died with hepatitis A in Utah, in January, March and August of 2018. Two of those deaths involved homeless individuals and another was associated with the outbreak. All three deaths involved other underlying health conditions or other contributing factors, Barbeau said.

Hepatitis A is one of many diseases required to be reported in Utah. More information about hepatitis A is available online at health.utah.gov/hepatitisA. Further questions should be directed to a health care provider.