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Here are questions and answers about Florida’s hepatitis A outbreak

Here are some frequently asked questions about the hepatitis A outbreak in Florida.

What is Hepatitis A?

Hepatitis A is a highly contagious virus that can cause serious liver damage.

How is Hepatitis A spread?

Hepatitis A is spread through fecal matter contaminated with the virus. It can be passed person-to-person by mouth (such as through eating or drinking food or water with the virus) or through sex or shared drug use. It can also be passed by sharing hygiene tools like toothbrushes or razors — the latter can cause tiny abrasions opening up the skin to the virus. Someone with hepatitis A can be contagious two weeks before symptoms start showing.

How did this outbreak start?

The outbreak likely started in the upper Appalachian region early last year, Florida Surgeon General Scott Rivkees said, and public health experts have linked the current rash of cases to the opioid crisis — tied to risk factors like IV drug use and homelessness — in that region. It has since spread south and west across several states.

Who is in danger of contracting hepatitis A? Who is high-risk or medically vulnerable?

The state has deemed about 491,000 people “high-risk,” referring to people who use recreational drugs or are homeless. It is also looking at people who are “medically vulnerable” — people with an underlying liver disease or who are over 60 with a chronic medical condition.

Federal officials recommend several categories of people get a vaccine, including people traveling to countries where hepatitis A is common or interacting regularly with people who have hepatitis A, men who have sexual encounters with other men, users of recreational drugs, people who are homeless or have unstable housing, people with chronic or long-term liver disease, or people with clotting-factor disorders.

Rivkees said the epidemic has involved adults, in part because children have been regularly vaccinated for hepatitis A since 2005.

How can I avoid getting hepatitis A?

The best way to avoid getting hepatitis A is to get a vaccine. It is usually given as two doses, six months apart. Practicing good hygiene — washing your hands and avoiding dirty surfaces — is also important. Hepatitis A can survive for days or weeks on surfaces like bathroom countertops. Public health experts have recommended sanitizing surfaces with bleach — the virus is not usually killed off by alcohol-based sanitizers.

At restaurants, hepatitis A can be killed off by heat, so people should also avoid eating anything uncooked such as seafoods or salads.

Where do I find a vaccine?

Talk to your healthcare provider or pharmacist about the vaccine and where to get it. You can also call county health departments, which Rivkees said are providing hepatitis A vaccines across the state. People who are high-risk, uninsured or underinsured people can get the vaccine for free. You can also use the site to find vaccine in your area.

If you’re not sure if you’ve been vaccinated, doctors can test to see if you’ve already received the vaccine.