Hepatitis A Outbreak Raises Concerns For Kentucky Derby

Kentucky Derby goers have more to think about this year besides what hat to wear and which horse to bet on.

The state of Kentucky is experiencing an outbreak of the potentially deadly virus hepatitis A with more than 400 reported cases and three deaths in the past year.

Health officials in Indiana issued a warning in April to anyone traveling to the Kentucky Derby recommending they get vaccinated for Hepatitis A before they travel to Louisville.

However, Kentucky officials are trying to alleviate concerns of travelers. Dr. Jeffrey Howard, Kentucky’s acting Commissioner for Public Health, noted what he calls “misleading information,” and has emphasized that the Centers for Disease Control and Prevention (CDC) has not issued a travel warning to those planning to attend the race, which takes place on Saturday and is expected to draw crowds of 150,000 people.

“Let me say that it is safe to travel to Kentucky and it is safe to attend the Kentucky Derby,” Howard said in a statement.

However, he also issued a statement in April urging residents of Kentucky counties affected by the outbreak to get vaccinated.

Dr. Amesh Adalja at the Johns Hopkins Center for Health Security said the Indiana recommendation is “an easy measure that can minimize risk.” He also said the average derby guest isn’t at high risk for contamination.

The greatest risk as shown in recent U.S. hepatitis A outbreaks is primarily to the homeless population with limited access to clean bathing and toilet facilities. Also at higher risk are illicit-drug users.

The hepatitis A virus is spread by what the CDC calls the “fecal-oral” route, involving contact with people and surfaces contaminated by feces that is then transferred orally.

Hepatitis A can cause a liver infection with symptoms appearing from two to six weeks after it is contracted. Symptoms include: fever, fatigue, nausea, vomiting, joint pain, jaundice (yellow skin and eyes), and dark yellow urine.

Most people who get the hepatitis A virus usually get better without treatment, but older adults and people with compromised immune systems are at a greater risk of serious illness or death.

Preventing hepatitis A can be as simple as washing one’s hands frequently, but a big concern is the transfer of the disease through contaminated food. Infected food workers who fail to properly wash their hands could potentially spread the infection to a large number of people.

Louisville’s Courier Journal has published a list of three restaurants where employees have recently been diagnosed with hepatitis A. Health officials have strongly advised people who dined at these locations during certain dates in April to get vaccinated.

People wanting to get the vaccine should know that the hepatitis A vaccine involves two doses, six months apart. As the Kentucky Derby nears, the CDC says that getting the first dose before travel can be effective in protecting against the disease.

Kentucky’s acting Commissioner for the Department of Public Health Howard stressed the importance of taking precautionary measures by getting the vaccine and practicing “good hand hygiene” to reduce the spread of the virus.


The vaccine is not recommended for people with allergies to a component in the vaccine that could cause severe or life-threatening reactions. People with illnesses beyond the level of a cold should wait until they recover and get advice from their doctor before getting the vaccine.

Currently, 22 states require school children to receive the hepatitis A vaccine.

The city of San Diego experienced a deadly hepatitis A outbreak last fall with more than a dozen deaths and a large effect on the homeless community.