Infectious Diseases & Outbreaks
Use of intravenous drugs significantly increases the risk of contracting Hepatitis B, Hepatitis C, and HIV. Northern Kentucky has seen dramatic increases in Hepatitis B and C rates, with many cases being associated with IV drug use.
Infectious Disease Manual
This manual is a resource for Northern Kentucky child care providers on issues related to communicable diseases.
While much of the information is targeted toward the child care provider, the manual can be useful to the general public.
The manual was created in 2005, updated in April 2015, and again in September 2023.
Diseases by Type
Guidelines and Resources
Additional Material
Additional information
In child care settings: Contact the Health Department’s Child Care Health Consultant Susan Guthier at Susan.Guthier@nkyhealth.org or 859-363-2090.
In other settings: Contact the Health Department’s Epidemiology staff at 859-363-2070.
Hepatitis C
Hepatitis C is a liver infection caused by the Hepatitis C virus (HCV) that is spread by contact with infected blood. Today, most people become infected with HCV by sharing needles or other equipment to prepare or inject drugs. The infection can range from a mild illness lasting a few weeks to a serious, lifelong illness. It can be described as “acute,” meaning a new infection, or “chronic,” meaning lifelong infection.
Many people with Hepatitis C do not have symptoms and do not know they are infected. Symptoms include fatigue, fever, nausea, decreased appetite, muscle or joint pain, dark urine, grey-colored stool, and yellow skin and eyes.
Hepatitis C can cause serious liver damage, including cirrhosis and liver cancer. It is the No. 1 reason for liver transplants in the United States. Liver damage from Hepatitis C can be prevented by early diagnosis and timely access to care and treatment. Unlike Hepatitis A and B, there is no vaccine to prevent Hepatitis C; however, Hepatitis C can be cured and treated.

Testing & treatment for Hepatitis C
NKY Health provides free testing for Hepatitis C, as well as referrals for those who need treatment. For a free Hepatitis C test, call to make an appointment at your county health center or schedule an appointment online at the:
- Boone County Health Center
- Kenton County Health Center
- Campbell County Health Center
Testing appointments are only available Mondays between 8:00 a.m. and noon.
If you learn you are infected with Hepatitis C, it is important you receive proper medical care. A health care provider can monitor your liver disease, advise you on how to take care of your liver, and provide information on treatments. Hepatitis C is curable in many cases. Medications now available for the treatment of Hepatitis C are more successful, have fewer side effects, and shorter treatment span (8-12 weeks).
Additional Resources
Linkage to Care – Hepatitis C Patient Resource Guide
Provider Resource for Hepatitis C Education Guide
For more information, visit www.cdc.gov/hepatitis/hcv.
Benefind allows Kentucky’s families to access public assistance benefits and information 24/7 through an online application and account. Go to benefind.ky.gov.
For information on signing up for health insurance, visit the Kentucky Health Benefit Exchange at kyhbe.ky.gov/general/agentorassister.
For local help signing up for medical benefits, contact the Northern Kentucky Community Action Commission (NCAC) at www.nkcac.org.
For resources on substance use treatment, visit findhelpnowky.org, or call the NKY Addiction Helpline at 859-415-9280.

Hepatitis B
Hepatitis B is a contagious liver disease. It can result in a mild illness that lasts several weeks (acute Hepatitis B) or a serious, lifelong illness (chronic Hepatitis B). It is preventable through a vaccine.
In 2015, there were 22 cases of acute Hepatitis B in Northern Kentucky, a rate of 5.37 per 100,000 population. In comparison, the state case rate is 3.7 per 100,000 and the national rate is 1.1 per 100,000 (state and national rates are based on preliminary numbers). Local cases of Hepatitis B doubled from 2006 to 2013, and 50 percent of those with Hepatitis B who were contacted by the Health Department admitted to IV drug use as a risk factor for the infection.
Tuberculosis
Tuberculosis, or TB, is an illness caused by bacteria. It usually infects the lungs. If not treated properly, TB can be fatal.
Testing
TB skin tests are available by appointment at the county health centers. Please call the center most convenient for you to schedule an appointment.
(Please note that the Health Department’s fees for TB testing may be higher than other providers. If you are required to have the test for job or volunteer position, please check that the agency doesn’t offer TB skin tests for free or at a reduced rate.)
Testing can also be done through St. Elizabeth Healthcare’s business health office at 859-301-2999 or at retail health clinics inside local grocery stores and pharmacies.

Services for those with TB
Health Department staff provide the following services to individuals with TB who live in or are visiting Northern Kentucky:
- Case management
- Case investigation
- Treatment
- Medication assistance
Reporting a case
Active or symptomatic TB disease is reportable in Kentucky. To report a case, call 859-363-2120. Healthcare providers, fax 859-363-2057.



Pertussis (Whooping Cough)
Pertussis is a highly contagious, respiratory illness caused by the bacterium Bordetella pertussis. People of any age can get pertussis, however children who are too young to be fully vaccinated and those who have not received all vaccinations are at highest risk for severe illness and death.
Though pertussis vaccination (DTaP or Tdap) is available and widely implemented, B. pertussis continues to spread in the United States due to lack of vaccination or timely boosters, the lack of lifelong immunity from vaccination or natural infection, and the long duration of infectiousness in untreated cases.
Symptoms of pertussis usually begin with a runny or congested nose, a low-grade fever, and mild coughing; apnea/stopping breathing can also occur in infants. After 1-2 weeks, the cough can progress to rapid, violent (paroxysmal) coughing fits that can cause the “whooping” sound, vomiting, and labored breathing. Most teens and adults will have mild symptoms; young children are the most severely affected.
Additionally, new parent and prenatal provider toolkits are now available to support immunization outreach efforts for pregnant Kentuckians. Pertussis can be life-threatening in young infants. Prenatal Tdap and prompt initiation of DTaP vaccines starting at 2 months of age are the best prevention against severe pertussis.
Health Alert
Cases of pertussis have continued to increase steadily in Kentucky, with numbers elevated to a rate not seen since 2017. As a result, the Kentucky Department of Public Health issued a Health Alert on July 17, 2024. A complete copy of the Alert can be read here.
Mpox
Mpox is a disease caused by infection with the Mpox virus. The Mpox virus is part of the same family of viruses as variola virus, the virus that causes smallpox. Mpox is not related to chickenpox.
Signs & symptoms
Symptoms of Mpox can include:
- Fever
- Headache
- Muscle aches and backache
- Swollen lymph nodes
- Chills
- Exhaustion
- A rash that can look like or become painful, itchy, pimples, blisters, pus-filled sores or lesions that can appear on the face, inside the mouth, on or around the genitals or anus, or other parts of the body

The illness typically lasts 2-4 weeks. Sometimes, people get a rash first, followed by other symptoms. Sometimes people can experience flu-like symptoms before the rash. Others only experience a rash. Though most people do not require hospitalization, serious complications can develop in some people infected with monkeypox.Infected persons are considered contagious as soon as symptoms begin until the time the sores or lesions have completely healed (scabs are gone and new skin has formed).
Who can get vaccinated for Mpox?
How do I get a Mpox vaccine?
NKY Health is offering vaccines as post-exposure prophylaxis to close contacts of confirmed Mpox cases to prevent onset of symptoms and reduce further community transmission.
NKY Health is also vaccinating individuals who are at higher risk of Mpox exposure.
Individuals interested in getting an Mpox vaccine should call the nearest county health center.



West Nile Virus
West Nile can be a serious threat to human and animal health. The most serious effect of West Nile is fatal encephalitis, which is an inflammation of the brain, in humans and horses. West Nile also kills certain species of domestic and wild birds.
Learn more about West Nile virus, including symptoms and transmission.
Prevention
The best way to prevent infection with the West Nile Virus is to prevent mosquito bites.
West Nile response
Testing Mosquitoes
Testing over the last several years has confirmed the presence of the virus in our region each year, thus it is safe to assume that local mosquitoes could carry the virus.
Humans
Individuals who may have contracted West Nile virus can be tested through local health care providers.
Case reporting
Human cases of West Nile virus are required to be investigated by the Health Department. West Nile virus is a reportable disease in Kentucky.
Mosquito control
In some instances, the Health Department may be able to implement measures to control the mosquito population in certain areas. If you have a concern about mosquito infestations in Boone, Campbell, Grant or Kenton Counties, please file a public health complaint.
Covid, Cold, Flu & Respiratory Infections
Covid, Cold, Flu, and respiratory infections ramp up in the Fall and Winter. The best advice to prevent these illnesses is to avoid others who are sick, stay away from others if you are sick, and get vaccinated, if you are eligible. Washing hands, avoiding places with large crowds, cleaning and sanitizing commonly touched services, keeping hands away from your mouth and face, sneezing and coughing into a tissue and throwing it away immediately are also effective in preventing illness.
For information on respiratory illness, data, and isolation guidelines, see the Kentucky Department of Public Health’s Respitatory Viruses Page.

Flu
Each Fall, the flu impacts more than 27 million people, according to the CDC, with up to 650,000 people hospitalized as a result.
Receiving an annual flu vaccine is a key preventative tool to fighting the illness, and is especially important for people who are at higher risk of developing complications, such as children under 5 years old, those with a respiratory condition, heart disease, or a weakened immune system.
If you test positive for the flu: Stay home and reduce contact with others to avoid spreading the virus, rest, drink plenty of liquids, and practice good hygiene. Wearing masks is a good practice as a means of protecting others.
For more information on the flu and flu vaccines, visit our Covid, Cold & Flu page.
If you are in need of a flu vaccine, contact your primary care physician or local pharmacy. At our four county health centers, NKY Health offers flu vaccines through the vaccines for children program and in limited amounts for adults who are uninsured or have Medicaid.
Respiratory Infections
In addition to the flu and now Covid, other respiratory infections are common starting each Fall, including respiratory syncytial virus (RSV). Vaccines are now available for infants and for adults over the age of 60. Contact your primary care physician or local pharmacy.
Covid
While COVID is no longer a national health emergency, the virus is not going away and should be considered part of our everyday lives, much like the flu.
Also like the flu, COVID remains a virus that can cause severe health risks, particularly among the elderly, people who are immunocompromised, or those with respiratory illnesses.
It is recommended that each person consult with his/her primary care physician to determine risk levels and an appropriate course of preventative care. Vaccines are highly recommended. Good judgment should be exercised during travel and as the weather forces activities to move indoors.
Tests can be purchased at local pharmacies to determine if an individual has Covid. If a test is positive, treatment should be approached much like the flu: Stay home and reduce contact with others to avoid spreading the virus, rest, drink plenty of liquids, and practice good hygiene. Wearing masks is not required, but is still a good practice as a means of protecting others.
Contact your primary care physician or local pharmacy to purchase a COVID vaccine. Our four county health centers are only offering the vaccines for children and in limited amounts for adults who are uninsured or have Medicaid.
Those who are disabled may be able to receive a vaccination at home. Contact DIAL (Disability Information and Access Line) at 888-677-1199 to determine eligibility and schedule an appointment.


HIV/AIDS
The only way to find out if you are infected with HIV is to get tested. The Health Department provides anonymous and confidential HIV testing and counseling, with results available during your visit.
Testing
Free testing is available at any of our weekly SAEP events or community outreach events. Free takehome self-testing kits are also available at our four county health centers and our outreach events.
What happens if my test is positive?
If your test is reactive, you will have to have a blood test to confirm the HIV infection. Health Department staff will provide the confirmatory testing and help link you to medical care and case management services.
Prevention
- Condoms: Condoms can reduce the risk of sexually transmitted diseases, including HIV. NKY Health provides free condoms at each of our four county health centers (ask for the brown bag) and at our free vending kiosks. NKY Health also provides some local businesses with condoms for their distribution.
- PrEP: Pre-exposure prophylaxis, or PrEP, is a way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day. More about PrEP. If you are interested in PrEP, talk to your primary care doctor or family doctor. If she or he is unwilling to provide PrEP, contact the PrEP clinic at University of Cincinnati at 513-475-8585 to schedule an appointment. No referral is required. PrEP locator: A national database of U.S. PrEP providers can help you find PrEP in your area.
Sexually Transmitted Infections
The Health Department provides testing and treatment for sexually transmitted infections by appointment at the county health centers. To schedule an appointment, call the health center that is most convenient for you. All services are confidential. Same-day appointments may be available.

Testing
Testing is available for common sexually transmitted infections, including:
- Chlamydia
- Gonorrhea
- Hepatitis C
- HIV
- Syphilis
- Trichomoniasis (available for females only)
- Herpes (swab test only)
Note: Genital warts are diagnosed through physical examination.
When to be tested
Many sexually transmitted infections do not have symptoms. Screening and/or testing for sexually transmitted infections is recommended when:
- You know your partner tested positive for or has a sexually transmitted infection
- You are ending a sexual relationship
- You are beginning a new sexual relationship
- You have any signs or symptoms of infection such as sores, bumps or blisters near your genital area, rectum or mouth; pain or burning with urination or bowel movements; vaginal discharge or order, or flu-like symptoms
- Men: If you have a drip or discharge from the penis or burning with urination
What to expect at an appointment
- A nurse will take your medical history to determine your risk of infection.
- A nurse practitioner or doctor will do a physical exam and testing.
- Depending on your results, treatment may be needed. This can often be provided at the health center.
- If necessary, health center staff can help you notify your partners.
Cost
While many services provided by the Health Department are available at a low cost to clients, most services are not free. It can be hard to know ahead of time what health services an individual may need, and so predicting the cost in advance can be difficult.
The Health Department provides many programs on a sliding-fee scale, based on the patient’s income and household size. Kentucky Medicaid is accepted, as are credit/debit cards. Payment plans can be setup if needed.
No one is turned away for inability to pay.
How to prevent sexually transmitted infections
- Use a condom or be sure your partner uses a condom every time you have sex.
- Limit the number of your sexual partners over your lifetime
- Only have sex with your partner
- Don’t have sex if you are intoxicated on alcohol or drugs
Reporting Infectious Diseases
Physicians and hospitals are required by state law to report certain communicable diseases to the Health Department. Qualified Health Department staff provide investigations of the cases and report the communicable diseases to the state office which reports to Centers for Disease Control and Prevention. To report diseases, using the following contacts:
- Sexually transmitted diseases: 859-363-2075
- HIV: 859-363-2072
- Tuberculosis: 859-363-2120
- Other notifiable infectious diseases 859-363-2065 or 859-363-2071
- To report cases after hours or to talk to the on call epidemiology staff member, please call 859-391-5357
Providers may also use the Kentucky reportable disease form to report certain illnesses. Please note that this form is to be used by medical providers only. Completed forms should be faxed to 859-363-2057.
