{"id":29080,"date":"2020-02-10T09:10:41","date_gmt":"2020-02-10T16:10:41","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=29080"},"modified":"2024-12-24T08:42:11","modified_gmt":"2024-12-24T15:42:11","slug":"hepatitis-a-outbreak-colorado","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/hepatitis-a-outbreak-colorado\/","title":{"rendered":"UCHealth introduces successful program to identify and vaccinate at-risk population during Hepatitis A outbreak"},"content":{"rendered":"
<\/div>

Hundreds of people at risk of hepatitis A infection, amid a national outbreak, received vaccinations through an innovative program that started last fall at UCHealth.<\/p>\n

\"A
Maggie Schump, associate nurse manager at the emergency department at UCHealth Poudre Valley Hospital in Fort Collins, holds a hepatitis A vaccine. Photos by Robert Allen.<\/figcaption><\/figure>\n

When a patient receives care in the emergency department of any UCHealth hospital across Colorado, certain information in their electronic health records \u2013 such as homelessness \u2013 can trigger an order for the potentially life-saving vaccine.<\/p>\n

UCHealth vaccinated more than 350 people to-date through the initiative, which went live at all the hospitals by early December. The process also pulls information to ensure the patient wasn’t already inoculated.<\/p>\n

\u201cIt opens your eyes, because I thought \u2013 just wow \u2013 we really have that many people who we see who are at risk,\u201d said Dr. Michelle Barron, an expert on infectious diseases and medical director for Infection Control and Prevention at UCHealth University of Colorado Hospital<\/a>.<\/p>\n

Most insurance plans cover the vaccine\u2019s cost. But UCHealth makes sure price doesn\u2019t get in the way for any of the patients at elevated risk.<\/p>\n

\u201cWe as an organization decided it was important enough that if there are folks that are self-pay or not insured with Medicaid or elsewhere, that we would bear the burden of the cost,\u201d said Dr. Kelly Bookman, senior medical director with the UCHealth Emergency Medicine Service Line<\/a>.<\/p>\n

The hepatitis A outbreak in Colorado<\/strong><\/h3>\n

The virus causing hepatitis A<\/a>, an inflammation of the liver, most often spreads through food or water that has been contaminated by infected stool. It can also spread from person to person. Symptoms include fever, fatigue, jaundice (yellowing of the skin and whites of the eyes), upset stomach, vomiting, diarrhea and more.<\/p>\n

The national hepatitis A outbreak affecting 32 states since 2016 has led to at least 30,696 cases, 18,604 hospitalizations and 307 deaths, according to the Centers for Disease Control and Prevention. The outbreak in Colorado began in October 2018 and has led to at least 347 cases, 248 hospitalizations and two deaths, according to the Colorado Department of Public Health and Environment<\/a>.<\/p>\n

Hepatitis A vaccine<\/strong><\/h3>\n

In addition to homelessness, risk factors that can trigger the vaccination order through the UCHealth initiative include incarceration, liver disease, drug use and more.<\/p>\n

\u201cI thought it made good sense from a public health standpoint and also a hospital standpoint,\u201d Barron said of the initiative, pointing to the rate of hospitalizations. \u201cSome have gotten incredibly sick.\u201d<\/p>\n

She said the emergency department isn\u2019t the ordinary setting for giving vaccines like this.<\/p>\n

\u201cMost care is really focused on that specific problem,\u201d she said. \u201cIt was a little novel in its approach.\u201d<\/p>\n

\"A
Nurse Mary Kreye, left, speaks with nurse manager Maggie Schump about the hepatitis A vaccine at the emergency department at UCHealth Poudre Valley Hospital in Fort Collins.<\/figcaption><\/figure>\n

Hepatitis A transmission<\/strong><\/h3>\n

CDPHE Communicable Disease Deputy Branch Chief Nicole Comstock said people experiencing homelessness, substance abuse issues and incarceration are especially susceptible.<\/p>\n

\u201cThe populations primarily affected by this outbreak can be hard to reach by traditional public health outreach practices, so we are grateful for UCHealth\u2019s partnership in working toward our goal of ending this outbreak,\u201d she said.<\/p>\n

\u201cWhen we have, say, an outbreak in a school or an outbreak in the community, we rely on mass media \u2013 news articles, social media, that type of thing \u2013 and sometimes, the populations experiencing homelessness may not have Facebook or check news or TV, newspapers, press releases or something like that.\u201d<\/p>\n

The state reports<\/a> the cases from Colorado\u2019s hepatitis A outbreak are spread across 18 counties. Most are in the Colorado Springs and Denver areas, but the report identifies a few as far as Montezuma, Mesa and Routt counties.<\/p>\n

After reaching a peak of 18 newly-reported cases one week in late September, the number of new cases of hepatitis A infection in Colorado appears to be going down.<\/p>\n

\u201cWe started seeing a decline in reported cases in the fall of 2019; however, we are still reporting between five to 10 new cases each week, so the outbreak is not over,\u201d Comstock said. \u201cWe\u2019re cautious, and we want to remain vigilant in keeping our vaccine efforts going until we\u2019re back to our baseline rates.\u201d<\/p>\n

She said the at-risk groups tend to move frequently to different geographic areas, and the turnover appears to become more frequent in springtime.<\/p>\n

Hepatitis A treatment<\/strong><\/h3>\n

\u201cProviding hepatitis A vaccine to at-risk groups remains the cornerstone of this response,\u201d Comstock said.<\/p>\n

The state reports that more than 22,000 vaccines have been given through public health funding sources recorded in a statewide system.<\/p>\n

To flag potential vaccine recipients in health care settings, UCHealth electronic health records experts not only developed a program to use across its emergency departments \u2013 they shared it with multiple other Colorado hospital systems.<\/p>\n

\u201cThe algorithm makes it very easy to identify these individuals,\u201d Barron said. \u201cIt\u2019s one of the things that I feel really excited about.\u201d<\/p>\n

Many hours of physicians\u2019 and analysts\u2019 time went into building the UCHealth program.<\/p>\n

\u201cWe weren\u2019t worried about the cost,\u201d Bookman said, adding that the initiative was driven by concerns for public health.<\/p>\n

\"A
Maggie Schump, associate nurse manager at the emergency department at UCHealth Poudre Valley Hospital in Fort Collins, holds a hepatitis A vaccine.<\/figcaption><\/figure>\n","protected":false},"excerpt":{"rendered":"

Hundreds of people at risk of hepatitis A infection, amid a national outbreak, received vaccinations through an innovative program that started last fall at UCHealth. When a patient receives care in the emergency department of any UCHealth hospital across Colorado, certain information in their electronic health records \u2013 such as homelessness \u2013 can trigger an […]<\/p>\n","protected":false},"author":2242,"featured_media":29086,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[8],"tags":[235,269,162,2683,1497,257],"class_list":["post-29080","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","tag-emergency-care","tag-emergency-department","tag-infectious-diseases","tag-u-s-centers-for-disease-control-and-prevention","tag-uchealth-university-of-colorado-hospital","tag-virus-prevention"],"acf":[],"yoast_head":"\nProgram 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A journalist for 12 years, he joined UCHealth in 2019 after reporting and editing at the Detroit Free Press. He is the author of Fading Ads of Detroit, a book exploring connections between classic Detroit brands found on ghost signs and in the personal histories of Detroit residents. His outdoor adventures include scrambling summits, hunting powder stashes via snowboard and rafting whitewater. He earned his bachelor's degree in journalism from Oklahoma State University and MBA from Colorado State University. He lives in Windsor with his wife, Rachel, and their obstinate pug, Darla.","url":"https:\/\/www.uchealth.org\/today\/author\/rallen\/"}]}},"coauthors":[{"id":2242,"name":"Robert Allen","link":"https:\/\/www.uchealth.org\/today\/author\/rallen\/"}],"_links":{"self":[{"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/posts\/29080","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/users\/2242"}],"replies":[{"embeddable":true,"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/comments?post=29080"}],"version-history":[{"count":10,"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/posts\/29080\/revisions"}],"predecessor-version":[{"id":79609,"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/posts\/29080\/revisions\/79609"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/media\/29086"}],"wp:attachment":[{"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/media?parent=29080"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/categories?post=29080"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.uchealth.org\/today\/wp-json\/wp\/v2\/tags?post=29080"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}