GLASGOW — All Kentucky students in grades K-12 will be required to have the Hepatitis A vaccine by July 1 in order to attend school.

The requirement stems from a recent outbreak of Hepatitis A, a highly contagious virus that can affect the liver.

“It’s been recommended since 2006, but it’s now being required,” said Sharon Ray, a communicable disease nurse with the Barren River District Health Department in Bowling Green.

Students will be required to get two doses of the vaccine.

“One is the initial dose and then one is six months later. That has been shown to give the most immunity,” she said.

If a student receives one dose prior to the start of the school year, Ray said they can go ahead and begin classes and get the second dose after school has started.

The vaccine is available through the local health department for students up to the age of 18 who qualify.

“Eligible children are those with no health insurance, those with health insurance that does not cover vaccines and children receiving Medicaid,” Ray said.

Significant outbreaks of Hepatitis A have been reported in Kentucky and Michigan.

The Kentucky Department for Public Health identified an outbreak of acute Hepatitis A last November.

Between August 2017 and April 7, Kentucky has had more than 300 cases of Hepatitis A and of those 300 cases, about 86 have been genetically linked to outbreaks that occurred in California and Utah, Ray said.

“In Kentucky, we average under 20 cases annually for the entire state. For the Barren River District, which consists of eight counties including Barren County, we average one case annually and we’ve had four cases,” she said.

An Associated Press article said three deaths have been reported as a result of the Hepatitis A outbreak in six counties and the Kentucky Department for Public Health is recommending Hepatitis A vaccinations for children age 1 and older and for adults living in Jefferson, Bullitt, Hardin, Greenup, Carter and Boyd counties.

Jeffrey Howard, acting public health commissioner for Kentucky, has said it is safe to travel to Kentucky and attend the Kentucky Derby, however, the Indiana State Department of Health has said residents should be vaccinated in order to protect themselves from the virus when traveling to states that have experienced outbreaks, the Associated Press article said.

Hepatitis A is most commonly associated with illicit drug use and homelessness.

“When you have an outbreak, eventually, it impacts people who are not in high risk groups,” Ray said. “Statewide, approximately 30 percent of the cases did not report risk factors.”

The infection is spread when a person unknowingly ingests the virus from objects, food or drinks contaminated by small undetected amounts of stool from an infectious person.

“The best ways to prevent Hepatitis A is to get vaccinated (and) practice good hand washing, especially before preparing meals and eating after using the bathroom or diapering a child,” Ray said.

Hands should be washed with warm water and soap. Most hand sanitizers that are alcohol-based are effective against bacteria, but don’t do well against viruses like Hepatitis A, she said.

Symptoms of Hepatitis A can include fever, nausea, vomiting, loss of appetite, jaundice, fatigue, stomach pain, dark pee or pale colored stool.

“Those symptoms may be mild enough that it doesn’t prompt someone to seek medical care,” she said. “Not everybody is going to have all the symptoms, so you might have some milder cases that may not even get recognized.”

A person who has Hepatitis A is infectious two weeks before they began exhibiting symptoms and then about a week after the symptoms start.

“That’s three weeks of infectiousness and when I say infectiousness that’s when they have the potential of shedding the most virus in their stool and then other people coming in contact with that,” Ray said.

She continued the district health department interviews people when there is an acute Hepatitis A outbreak in an effort to reach people with whom the sick has come in contact, because people can benefit from post exposure treatment if it is given within two weeks of the last risk of exposure.

Hepatitis A is also transmitted sexually and by using towels, toothbrushes, eating utensils and cigarettes shared with someone who is infectious. It can also be transmitted to someone who has eaten contaminated food.

“If we have someone who is in food service who has infectious diarrhea, we do not want those individuals to work. We want them to go to their doctor and tell their manager right away,” she said, adding that a food service worker with Hepatitis A could possibly transmit the virus by contaminating surfaces, utensils or food.

Those who are healthy can let Hepatitis A run its course without it causing long-term complications, Ray said.

“Any care would be supportive care,” she said, adding those who already have a liver condition can experience significant problems by contracting the virus.

Those who wish to protect themselves by getting vaccinated should see their doctor or primary care provider.

“The Hepatitis A vaccination is often covered by insurance plans. Adults can contact their local health department for an appointment and we accept most private insurance carriers,” Ray said.

In addition to being available at local health departments, the vaccine is available at the primary care offices at the TJ Health Pavilion, said Bart Logsdon, a spokesperson for TJ Regional Health.