State and local health officials are investigating five cases of hepatitis A in the Omaha metro area, and they’re asking health care providers to be on the lookout for more.

The five cases have been reported within the past three weeks, with symptom onset between Oct. 15 and Nov. 5. That means the five likely were exposed in mid-September, Adi Pour, director of the Douglas County Health Department, said Friday.

The five, all female, range in age from 14 to 73. Three of the five were hospitalized. Two have been released; health officials don’t know the status of the third hospitalized person.

Over the past 10 years, Pour said, the county has recorded between zero and four cases of the highly contagious viral infection each year.

The virus is transmitted primarily through the fecal-oral route, either by person-to-person contact or through ingestion of contaminated food or water. Often that occurs when food is contaminated by someone who is ill and hasn’t properly washed their hands.

It also can be transmitted by sexual contact, shared needles and blood transfusions, although those routes are less common.

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Pour said health officials so far have not identified a product or place connecting the individuals. They are spread throughout the community and have not had any known contact with one another. Health officials have excluded international travel and shared needles as possible routes of transmission.

Because outbreaks of hepatitis A have occurred in other states in recent years, she said, health officials have been working to determine whether the local cases are connected. They’re consulting with other states and sending samples to federal labs for genetic testing.

The Nebraska Department of Health and Human Services and the Three Rivers Public Health Department in Fremont, which serves Dodge, Saunders and Washington Counties, also are involved in the investigation.

The state sent an alert about the cases to health care providers Friday. Health care providers are required to report hepatitis A to the state or local health departments. But Pour said the alert was not intended as a warning to the public.

“I don’t think anybody at this time needs to be concerned,” she said.

The virus, which attacks the liver, can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months. Symptoms can include fever, fatigue, loss of appetite, nausea, vomiting, joint pain and jaundice.

The incubation period for the virus is approximately 30 days. Individuals are considered most contagious during the two weeks before and one week after symptoms begin.

Those who are diagnosed with hepatitis A or people who have developed symptoms after being exposed to it should not work or prepare food for a week after symptoms begin and until symptoms are gone for more than 24 hours.

Those who have had hepatitis A are considered immune to the virus. Those who have been vaccinated for it are much less likely to get it but still can be infected.

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Julie Anderson is a medical reporter for The World-Herald. She covers health care and health care trends and developments, including hospitals, research and treatments. Follow her on Twitter @JulieAnderson41. Phone: 402-444-1066.

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