KOSCIUSKO — Hepatitis A is a viral infection that affects the liver.

People who are becoming ill with hepatitis A can pass on the disease to others before they have any signs of illness. Symptoms begin 15 to 50 days after exposure, usually at about one month. Symptoms of hepatitis A include loss of appetite, nausea, vomiting, diarrhea, fatigue, stomach pains, fever, dark urine, pale stools and jaundice, which is yellowing of the eyes and skin.

Hepatitis A is an oral-fecal disease, so the risk of the disease is higher in unsanitary conditions. Hepatitis A can become a public health emergency if an infected person is a food worker. This can require mass immunization of involved individuals.

Hepatitis A is a vaccine-preventable disease and the vaccine provides protection to most people even after only the first shot. The second shot is due six months later to complete the series.

Indiana and several other states have outbreaks of hepatitis A. Most of these outbreaks have occurred in high-risk populations, homelessness and illegal drug use being the most recent. But even if you are not in a high-risk category it does not mean you cannot get the disease.

For the last decade, Kosciusko County has one case or less per year and all of those cases were tied to travel. To date, in 2018, Kosciusko has had eight confirmed cases of hepatitis A and no cases with foreign travel. Almost half of the cases in Kosciusko County did not belong to a high-risk group.

The Kosciusko County Health Department Clinic at 1515 Provident Drive carries hepatitis A vaccine for all ages. If you want to talk with someone about hepatitis A vaccine you can call the clinic at (574) 267-7028. The immunization has walk-in clinics from 8:30 a.m. to noon, then reopens at 1:15 to 4 p.m. Mondays, Wednesdays and Fridays. On the first Monday of the month, the clinic reopens at 4:30 and closes at 6 p.m.

For children 18 and younger, hepatitis A is a recent phasing in addition to Indiana schools’ vaccine requirements. For children, Kosciusko County Health Department has VFC, or Vaccines for Children from federal funding for children with Medicaid, no insurance, and under-insurance, American Indiana or Alaska Native. Vaxcare is available for children and accepts most local insurances.

For adults, the Kosciusko County Health Department has Vaxcare, which can accept most insurances, and 317, an ISDH program for uninsured and underinsured adults. For adults using 317 there is an $8 administration fee for each shot but if this is a hardship, the cost can be waived with a financial hardship form.

Adult Medicaid is not accepted through Vaxcare and adults with Medicaid can seek vaccination through their physician or pharmacy.

Many pharmacies now carry vaccines and can be a convenient choice for insured adults. Often the pharmacy may have standing orders and may be able to check insurance and give the vaccine to an adult requesting to receive the hepatitis A vaccine.