Investigation: Several diseases spiked in Butler County in 2018. Here’s why.

Credit: DaytonDailyNews

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Understanding Hepatitis A

Credit: DaytonDailyNews

Editor's Note: The Journal-News spent March investigating the most important issues facing Butler County and its residents. One of those investigations was into an issue that can face all residents: Diseases, including which are prominent in the county. This story first published on Sunday, March 10.


A variety of infectious diseases appeared more frequently in Butler County during 2018 than the prior five years. In some cases, there were huge spikes that propelled the county into leading the state, according to a Journal-News analysis of data from the county.

Those included sexually transmitted diseases like chlamydia, gonorrhea and syphilis, as well as other diseases, such as hepatitis A, B and C.

Butler County Health Commissioner Jenny Bailer said a major cause for these increases is a simple one: Another effect of the drug epidemic that has struck the region and country.

“There’s a lot of disease fallout from drug use,” Bailer said. “And it’s not just the ones that we think of immediately. I think the public pretty much knows about HIV and hepatitis C being associated with drug use. But there are a lot of other diseases that are also associated with drug use.”

With hepatitis A, Butler County experienced a severe outbreak in 2018 that continues this year. Between 2013 and 2017, Butler County averaged one case hepatitis A per year. Last year, there were 308 cases. With gonorrhea, the average year in that period saw 456 cases. Last year, there were 654.

ExploreRELATED: Hepatitis A cases remain high in two local counties

Butler County’s cases of hepatitis A were so prevalent that, until Monday, it had more cases than any of Ohio’s 88 counties this year. That changed Monday, when the Ohio Department of Health reported that Franklin County, home of Columbus, had 284 cases to Butler’s 283.

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Butler County Health Commissioner Jenny Bailer. ARCHIVE

Butler County Health Commissioner Jenny Bailer. ARCHIVE

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Butler County Health Commissioner Jenny Bailer. ARCHIVE

Two Butler County people died from hepatitis A in 2018: a 75-year-old man, and a 42-year-old woman.

Warren County in 2018 had 33 cases of hepatitis A (up from four in 2017), 54 of hepatitis B (down from 74 in 2017) and 245 of hepatitis C (down from 345).

Typically, people with hepatitis A feel sick for a time before the symptoms subside. But with the recent hepatitis A outbreak, 60 percent of people experiencing it have been hospitalized to the point many have been placed in intensive care, county health officials said.

Even when people are not hospitalized from hepatitis diseases and their symptoms go away, they face issues with their liver, and “the liver is critical to your body functioning properly,” Bailer said.

From 2013 through 2017 — the most recent year tracked by the health department — Butler County had 971 overdose deaths. The 232 deaths in 2017 were more than double the number in 2012. The number of deaths increased every year during that period.

ExploreRELATED: Recovering Preble County addict: ‘I didn’t want to die a junkie’

Bailer applauded Middletown for its efforts to curb not only the opioid epidemic but also the spread of diseases through its use of a Hamilton County Public Health van that visits a parking lot in the 400 block of Crawford Street on Tuesdays and provides a range of help for drug addicts.

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This Public Health truck stops once a week in Middletown as a place for addicts to exchange dirty needles for clean needles. The truck is parked next to building on Crawford Street. ED RICHTER/STAFF

This Public Health truck stops once a week in Middletown as a place for addicts to exchange dirty needles for clean needles. The truck is parked next to building on Crawford Street. ED RICHTER/STAFF

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This Public Health truck stops once a week in Middletown as a place for addicts to exchange dirty needles for clean needles. The truck is parked next to building on Crawford Street. ED RICHTER/STAFF

Among those things that help the addicts’ health are exchanges of used needles for clean ones — so the needles aren’t used repeatedly by more than one person, which can spread diseases like hepatitis. The van also gives hepatitis A vaccinations, tests for HIV and other sex-related diseases, performs pregnancy tests, hands out condoms, provides the overdose-battling drug Narcan, offers referrals to drug rehabilitation and provides underwear and socks to those in need.

“They’re not just coming for the clean needle,” said Middletown Health Commissioner Jackie Phillips. “They come for condoms, or they come for testing, or they come for referrals.”

With the van assistance, health officials also come into contact with addicts who otherwise would be hard to find and offer help, Phillips said. Health officials can see if they have infections or are jaundiced. Sometimes, visitors are so sick that the health providers call the emergency squad for immediate help.

ExploreMORE: Butler County doubles funding for opioid fight
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Jackie Phillips, Health Commissioner for the city of Middletown. ARCHIVE

Jackie Phillips, Health Commissioner for the city of Middletown. ARCHIVE

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Jackie Phillips, Health Commissioner for the city of Middletown. ARCHIVE

During 2018, the van in Middletown served 2,544 people. In January 2019, it served 942.

Without the van, there would almost certainly be more deaths, more overdoses and more dirty needles in neighborhoods, Phillips said.

Phillips credits Middletown City Manager Doug Adkins for that city’s aggressive approach toward the opioid epidemic.

Several years ago, Phillips said she went to a harm-reduction conference and recommended to Adkins the idea of a needle exchange for Middletown. She said he asked her, “Are you crazy?” And she said, “‘Kind of,’ and we talked and laughed,” she said.

The city later declared an emergency because Middletown was seeing high rates of hepatitis C, “and Middletown was very proactive because we knew there was a problem,” Phillips said. “We were seeing the overdoses every month. I was reporting deaths every month to the (health) board. I was reporting high rates of hep C to the board, and I said, ‘We’re a health board. We need to respond.’”

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“The board all came along, and Doug really was the one who not only was very supportive,” she said. “He did a blog, and when people said, ‘Why are we doing this?’ he took all the hits, answering back, ‘We all feel uncomfortable about this, but we have this going on in our community, and we want to be proactive and do something.’”

ExploreRELATED: With Middletown’s overdoses dropping dramatically, what’s next in the heroin battle?

Fairfield Councilman Bill Woeste, chairman of the Fairfield Opiate Task Force, said the bloodbourne-disease van “takes unhealthy people and allows them to get healthier or keep them from getting sicker.”

“Let’s imagine there’s a handful of people out there working in restaurants that have hepatitis A,” Woeste said. “Any one of us now are susceptible to that, if they haven’t done their due diligence, cleaning their hands, doing what they need to do.”

With people turning in used needles for clean ones, “There’s a decrease in dirty needles around areas because a needle now is a commodity, so if you find five dirty needles, you get five clean,” Phillips said.

The bottom line, officials said, is that services like the health van provide help to those who often struggling, but it benefits everyone around the community to make sure they’re cared for.

“This is a reason I felt strongly about it,” Phillips said, explaining her advocacy of the health van. “The residents that we’re talking about are residents of ours. They’re your people, regardless of whether you like it. So you have to be mindful of your people. I always say you have take the good, the bad, and the not-so-pretty. All of them are your residents, and so you have to be mindful of what your community needs.”

ExploreRELATED: Opioid overdoses trending down in Middletown


How can you get help?

If you live in Butler County, here are two ways you can get help with drug addiction and related problems:

  • Call the Crisis Hotline, which can help with addiction issues, suicide, mental health and other problems. The number is (844) 427-4747.
  • Dial 211 for United Way's Help Link, or the alternate number, in case 211 doesn't work in your area, (855) 405-7629.

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