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Hepatitis A spreads through borough

March 18, 1993

By Michael Gerhardt
Arctic Sounder

An outbreak of hepatitis A in the Northwest Arctic Borough will likely spread to all villages served by the Maniilaq Association, the agency's director of medical services said.

Since August, 144 cases of hepatitis A have been confirmed in the NANA region, according to Maniilaq.

"Currently, over half of our villages are affected," said Dr. Janet Shackles, director of medical services at Maniilaq. "I'm expecting it to spread to the rest."

The current outbreak of hepatitis A is not as serious as the epidemic which swept through the region in the mid-1970s, Shackles said. But the way the disease is spreading now is very similar to outbreaks of the past, she said.

"The epidemic that went through 10-15 years ago burned out in about a year, year and a half, and that's what I'm expecting here," Shackles said.

"But that's just the way the disease spreads and will probably be the course it will take over the next year or so," she added.

Selawik has been hardest hit with 63 cases, said Ruth Storms, manager of the public health nurse program at Maniilaq. Kotzebue, Noorvik, Buckland and Shungnak have also been affected.

Concern about the disease, like the disease itself, has spread throughout the region.

Officials at both NANA Corp. and Friends Church said they considered moving their meetings next week from Noorvik to Kotzebue because of the disease.

Last week at an elementary school in Kotzebue, students were reminded by a teacher to wash their hands carefully.

The issue was discussed last Friday at a sub-regional strategy meeting in Kotzebue and has been the focus of educational outreach by community health clinics in villages.

"Initially, people were worried about hepatitis A," said Sally Harvey, supervisor of the community health clinic in Noorvik. "They were kind of terrified."

Now that most people have learned about the disease, they are not as scared of it, Harvey said.

Noorvik is reported to have had 37 cases of hepatitis A since August. About 20 Noorvik residents now have the disease, Harvey said.

When cases of hepatitis A started showing up in Selawik last year, village residents felt like they were being blamed for the start of the disease, said Emma Ramoth, supervisor of the Selawik clinic. "It seems like they started blaming us and we started feeling bad about it," she said.

Selawik hasn't seen any new cases of hepatitis A in the last two weeks, Ramoth said.

Public concern over the disease rose last January in response to the death of a 14-year-old Shungnak student.

Shannon Ryan Woods, a high school freshman, died of "fulminated hepatitis A," according to Joyce Portman, a nursing supervisor at the Alaska Native Medical Center in Anchorage. Fulminated means the ninth-grader was hit with a sudden and intense case of the virus.

Hepatitis A, which attacks the liver, is rarely fatal and rarely causes serious complications, Shackles said.

Around 95 percent of the people who get hepatitis A recover from the disease, she said.

There is no treatment for hepatitis A — it must be prevented.

The disease is spread through close personal contact in households, day care centers, by sexual contact, and when someone eats or drinks food contaminated with feces from an infected person. This usually happens when a person fails to wash his hands after using the restroom and before preparing food.

However, hepatitis A is not spread by contact with saliva or by sneezing.

Someone with this virus is more likely to be contagious 10 days before feeling sick and until four days after jaundice appears. People don't usually spread the disease after the first week of jaundice, according a fact sheet from the North Carolina Division of Epidemiology.