Page 28 - Volume 70 Number 1
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Washtenaw County Public Health (WCPH)
Medical Director Report
By Jessie Marshall, MD, MPH
COMMUNICABLE DISEASE: Influenza: (as of December 21, 2017): Reports of lab-confirmed influenza are increasing in Washtenaw County. Influenza A/H3 is the dominant virus, currently, along with a few influenza B virus reports. Flu-related hospitalizations are also starting to rise.
Influenza-Associated Hospitalizations and Deaths in Washtenaw Residents: 2017-18*
*Flu Season starting Oct 1, 2017
Hepatitis A: Outbreak in Southeast Michigan: Public health officials and the Michigan Department of Health and Human Services (MDHHS) are continuing to see
an elevated number of hepatitis A cases in Southeast Michigan. Since the beginning of the outbreak in August 2016, public health response has included increased healthcare awareness efforts, public notification and education, and outreach with vaccination clinics for high-risk populations. No common sources of food, beverages, or drugs have been identified as a potential source of infection. Transmission appears to be through direct person-to-person spread and illicit drug use. Those with history of injection and non-injection drug use, homelessness or transient housing, and incarceration
are thought to be at greater risk in this outbreak setting. Notably, this outbreak has had a high hospitalization rate.
Southeast Michigan Hepatitis A Outbreak Cases and Deaths as of December 20, 2017*
Note: Table does not include all reported hepatitis A cases in the SE MI outbreak region; only those cases that are identified as outbreak- related. Data are provisional and subject to change.
Hepatitis A in Washtenaw County: As of Dec 20, there have been 630 cases of hepatitis A diagnosed in Southeast Michigan since Aug. 2016. In Washtenaw County, nine cases have been identified since the outbreak began last year. Eight of those cases have been reported in 2017.
Washtenaw County Cases
*Seven of the nine cases reported in 2017 have been reported since Oct. 1.
Note: Case counts are preliminary and may change as more information is available
Vaccination in Washtenaw County
Prior to the current outbreak, the average number of adult doses of hepatitis A vaccine given in Washtenaw County was about 90 per week. Since Oct 2017, that number has increased to over 370 doses per week for a total of more than 3,270 adult doses from Oct. 1-Nov. 18. (Data from Michigan Care Improvement Registry.) Washtenaw County Health Department has given over 1,270 doses of hepatitis A vaccine since Oct. 1, 2017. Learn more about the Southeast Michigan outbreak at
Agencies/organizations in Washtenaw County who service high-risk individuals have been advised to encourage and/or offer Hepatitis A vaccination. These high-risk groups for the current outbreak:
 People who use injection and non-injection illicit drugs
 Incarcerated individuals
 People who are homeless or who have transient
housing situations
 People who participate in commercial exchange of sexual practices
 Staff of healthcare centers, community service centers, and law enforcement agencies
SUBSTANCE ABUSE: The Opioid and Heroin Epidemic Washtenaw County Health Department is having internal discussions and working with the WHI Opioid Project and other community partners to further our efforts and work in responding to this epidemic. More information to come. Our county continues to see 1 or more opioid-related overdose deaths per week: September 2017 saw 6 deaths and October 2017 saw
7 deaths. As of October 2017, there have been 54 deaths compared to 48 through October 2016.
LOCAL PUBLIC HEALTH: We have a new name: Washtenaw County Health Department
Total Hospitalizations
Hospitalizations week ending 12/23/17
Total adult deaths
Total child deaths (0 - 17 years)
517 (82.1%)
20 (3.2%)
Most Recent Case Reported
Total Cases
Dec 12, 2017
28 Washtenaw County Medical Society BULLETIN

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