At least 15 confirmed cases and two deaths reported since Jan. 1, with two-thirds reported since April 1
MARTIN COUNTY – Fire-Rescue, government, health and law-enforcement officials held a press conference in Stuart April 5 to announce a hepatitis A outbreak in Martin County after the county listed its 13th confirmed case of the highly contagious liver infection. The Martin County Health Department reported two more confirmed cases the following Monday, bringing the total to 15 at press time.
The day prior to the press conference, the medical examiner’s office released the autopsy results of a Palm City couple, Jeffrey and Nancy Kirsch, both 62, who Martin County Sheriff’s deputies discovered dead in their home March 28 from complications related to hepatitis A. According to friends and family members, the couple told them they were fighting the flu.
Health Department Environmental Health Manager Todd Reinhold helped field questions from the media, emphasizing that people should not do as the Palm City couple did and self-diagnose.
“Self-diagnosing and reporting on your own is not the proper way to do it,” he said. “Proper hygiene and dealing with your physicians, that’s how we control this, that’s how we get through this.”
County Administrator Taryn Kryzda told those in attendance that Sheriff William Snyder contacted her about holding a public meeting April 4 upon learning the results of the Kirsch autopsies.
“The Health Department reached out to us and the sheriff, and that’s why we had our meeting this morning, so that we could bring those individuals together to make sure that we’re given the information and that we’re now communicating it to the public,” she said.
Martin County Fire Rescue Chief Bill Schobel began the press conference by assuring the public present that a hepatitis A outbreak was not uncommon and was a state-mandated classification when any county reports its fifth confirmed case of the year.
“What I want to let you know is, as a community, things are under control,” he said. “This is not an unusual thing to occur even throughout our nation. The state has identified approximately half the counties of having an outbreak. There are actually 1,200 cases statewide.”
When asked by a reporter if the cases were centralized in any particular part of the county, Mr. Reinhold stepped up to the microphone, emphasizing that HIPPA (Health Insurance Portability and Accountability Act) privacy rules prohibited him from releasing much information about individual cases.
“At this point, no,” he responded. “I can’t provide individual information, but at this point we’re not seeing that.”
For his part, the fire chief said officials had yet to isolate a particular source for the Martin outbreak when questioned about local shellfish, but both he and Mr. Reinhold emphasized regular hand-washing as a prevention tool and referred to the Florida Department of Health website for more detailed information.
“If anybody contracts this, they are questioned, because we want to isolate as quickly as possible,” Chief Schobel insisted. “But that’s only one type of source of where it could spread in Martin County. On the website, it talks about shellfish, it talks about any uncooked food or a salad bar and so forth. Unfortunately, it’s an oral fecal transmission, so it would have to be someone who didn’t provide good hygiene and then handled your unprepared food, and then you ate it.”
Mr. Reinhold emphasized that his office had been in contact with both the state Department of Business and Professional Regulation and the Florida Dept. of Agriculture to help get the word out locally for food service employees to be extra cautious.
“They are doing their due diligence and informing those areas where there are restaurants and to inform them of just basic hygiene,” he said. “It’s something that these restaurants and groceries go through on a daily basis: hygiene and hand-washing and making sure they’re implementing their policies.”
Sheriff Snyder also fielded questions about protections for his own officers who visited the Kirsch home both the day before they died and the next day, but he insisted his office only found out about potential exposure to the disease upon the release of the autopsy reports.
“First of all I was saddened -- I peripherally knew one of the victims in that case,” he said. “I was alarmed that people not in the target [high-risk] group -- you know we keep talking about my jail and we talk about homeless -- neither one of these fit that. These were your everyday persons, and we don’t know how they got it. So, we’ve offered the full service of the Martin County Sheriff’s Office to help backtrack it if the State Department [of Health] gets a lead.”
Commission Chairman Ed Ciampi also spoke to the reporters present but specifically addressed his comments to Palm City residents, where at least three of the county’s 15 cases have been reported.
“I’m a Palm City resident and a Palm City parent, so I just wanted to reassure -- not just the residents of Martin County, but specifically the folks that live in Palm City -- where tragically Mr. and Ms. Kirsch lived and passed away,” he said. “Our hearts go out to the Kirsch family. This is a very personal issue where two members of our community have lost their lives, and it’s sort of been the rally cry.”
Chairman Ciampi believes any concerned Martin County residents should seriously consider getting the two-part vaccination in addition to their regular hygiene methods.
“We’ve always heard about hand-washing, but I think the vaccine is a smart choice,” he said. “There is really no down side to having the vaccine and then it does, after the two [injections], sort of vaccinate you for life. So, considering there’s really no down side, why wouldn’t we consider that as a safety precaution?”
When asked by a reporter what he would take away from the outbreak news, Sheriff Snyder said he would do just that.
“I plan to get vaccinated myself,” he said. “Of course, you could say I’m in the high-risk group. Although most of my day is spent here safely in my office, I do go out on the streets. I think that anybody that eats out, eats at salad bars, eats sushi, -- yeah you can wash your hands all day long -- but if they’re serving you your salad, that’s not going to help you a whole lot.”
For his part, Chief Schobel attempted to prevent a vaccination stampede by insisting concerned residents visit their primary care physicians first if they think they may have contracted hepatitis A.
“You need to have a plan,” he said. “If you do come down with these symptoms, seek medical attention immediately and follow that care provider’s advice. The other thing is, if you’re worried about a vaccination, contact your primary care provider and they might provide it for you. Again, we don’t want to provide an overrun of the physician offices today.”
Mr. Reinhold concurred with that assessment.
“As far as our outreach efforts, the trigger on this was five cases for high-risk population, not mass vaccination of the entire public,” he said. “Of course, if you feel that vaccination is something you desire, then you can do that, and it is available at the local pharmacies.”
Chief Schobel said by the end of the day, both the Martin County and Sheriff’s Office websites would have a link to a document produced by the Florida Dept. of Health on the symptoms of hepatitis A and how to avoid contracting the virus.
Neighboring counties have not reported the same level of hepatitis A cases. St. Lucie County Health Department Public Information Officer Arlease Hall said her municipality has reported only two confirmed cases of hepatitis A to-date. She also recommended the www.flhealthcharts.com link from the Florida Dept. of Health website for people wanting to compare communicable disease rates around the state. According to that website, Martin County had no reported and confirmed cases of hepatitis A last year, while St. Lucie County reported two cases for 2018. Indian River County reported no cases for either of the two years in question. Palm Beach County has reported four confirmed cases of the virus as of April 9 of this year and had reported an outbreak last year with a total of 11 cases.