Metro Detroit jails new front in battle against hep A

James David Dickson
The Detroit News

The latest front in Michigan’s battle against hepatitis A is the jail system in the state’s three largest counties. For months now, jail inmates in Wayne, Oakland and Macomb counties who want the HepA vaccine can opt to receive it free of charge. Thousands have chosen to do so.

The Centers for Disease Control and Prevention describes hepatitis A as a “vaccine-preventable, communicable disease of the liver caused by the hepatitis A virus. It is usually transmitted person-to-person through the fecal-oral route or consumption of contaminated food or water,” and urges that vaccination is the best way to avoid contraction.

In southeast Michigan, health officials have offered vaccinations through the jail system, as well as the Detroit Detention Center and Detroit Re-Entry Center on the city’s east side.

Southeast Michigan has had 715 reported cases of hepatitis A and 24 deaths since the outbreak began in August 2016, according to statistics kept by the Michigan Department of Health and Human Services. That’s up 132 cases, and four deaths, from December. About 81 percent of people who’ve caught Hep A have been hospitalized for it.

The vaccine costs the state $25 per dosage, and the vaccine is purchased through the CDC, said Lynn Sutfin, spokeswoman for the Michigan Department of Health and Human Services.

Health officials say the majority of cases are among drug users, the homeless and current and former inmates.

Health officials say jail populations are vulnerable to hepatitis A infections because of the close quarters inmates share. In addition to the vaccinations at local county jails, county health departments have sought out homeless populations and substance abuse clinics to offer the vaccine.

Macomb County has had about 29 percent of the hepatitis A infections in southeast Michigan: 199 of the 692.

The Macomb County Jail has been offering the vaccine since July, said Sgt. Renee Yax, a spokeswoman for the Macomb County Sheriff’s Office, which operates the jail. Some 1,588 inmates have received the vaccine in the six months since. The jail gets the vaccine from the county health department, which gets it from the state health department, Yax said. Inmates can choose to be vaccinated during the intake process or at their physical exams.

The county administers vaccine to inmates and the homeless population it can reach, and at substance abuse clinics, Yax said — but most vaccinations it administers are done at the jail.

The Oakland County Jail began offering the vaccine in late August, officials said.

“The jail was made aware that individuals incarcerated were considered at high risk for contracting hepatitis A,” said Executive Lt. Melissa McClellan with the Oakland County Sheriff’s Office’s Corrective Services Division, and a collaboration between the jail system and the county health department was formed to vaccinate inmates.

In Oakland County, the plan is to vaccinate inmates “as close to intake as possible.” Nurses and medical support staff from the health department come to the jail Monday through Friday to educate inmates who’ve recently arrived, and offer them the chance to be vaccinated.

The county’s jail administers about 29 doses per day to inmates ages 17 to 76. Along with the almost 4,300 inmates to take the vaccine during that time period, 68 deputy sheriffs and 15 staffers also opted for vaccination. The county has 94 reported cases of of the disease since the outbreak started, or 13.5 percent of the total in southeast Michigan.

The vaccinations do not cost inmates anything, as they come from Michigan’s Adult Vaccination Program, administered by the Michigan Department of Health and Human services. From Aug. 29 through Jan. 11, the most recent numbers available, the jail analyzed the vaccination records of about 5,320 inmates, and found that 80 percent of them hadn’t been vaccinated. Of that group, 79 percent of inmates offered the vaccine accepted.

The hepatitis A outbreak began in Michigan in 2016, said Sutfin, the state’s health department spokeswoman. That year, Michigan had 112 people report contracting the disease. That compares to an average of 65 contractions in the five years before 2016, and represents 1.7 times the amount seen in those years. Sutfin said 2017 numbers are not yet available.

Wayne County has been hit the hardest by the outbreak, with 38 percent of the reported cases, 265 out of 692, when the numbers for Detroit and out-county are combined.

Since late November, about 1,100 people have been vaccinated through the Wayne County Department of Health, Veterans and Community Wellness, said Dr. Ruta Sharangpani, the department’s medical director.

Some 396 inmates have been vaccinated at the Wayne County Jail, meaning that one-third of all county-funded hepA vaccinations have taken place in the jail system. Another 21 staff members at the jail have opted for the vaccine.

Two Michigan Department of Corrections-run facilities in Detroit also offer free vaccines to detainees, said Chris Gautz, department spokesman. But few at the Detroit Detention Center have taken up the offer. At a facility that takes in about 350 inmates each week, only 81 inmates had opted for vaccination since it was first offered in late November.

Detroit Detention Center detainees stay at the facility 72 hours or less.

“A lot of times when someone comes into the Detroit Detention Center, a vaccination is the last thing on their mind,” Gautz said.

The numbers are a bit different at the Detroit Re-Entry Center, which shares a campus with the city jail and is a last stop for inmates nearing a return to freedom. At last count some 776 inmates are at the Re-Entry Center and, since late November, 131 have been vaccinated, said Holly Kramer, a corrections spokeswoman.

Staffers at the facilities were offered the vaccine at a flu clinic; 18 staffers at the Detroit Detention Center and nine at the Re-Entry Center took up that offer.