Urgent HAN update: Widespread outbreaks of hepatitis A among specific populations across the U.S.
The Health Alert Network (HAN) is strongly recommending that public health departments, healthcare facilities, and partners and programs providing services to affected populations vaccinate at-risk groups against hepatitis A, applying the updated recommendations of the Advisory Committee on Immunization Practices (ACIP). The last update was in June 2018.
Multiple states across the country have reported outbreaks of hepatitis A, primarily among people who use drugs and people experiencing homelessness. Since the hepatitis A outbreaks were first identified in 2016, more than 15,000 cases, 8,500 (57 percent) hospitalizations, and 140 deaths as a result of hepatitis A virus (HAV) infection have been reported. Hospitalization rates have been higher than typically associated with HAV infection. Severe complications have also been reported, sometimes leading to liver transplantation or death; at least 140 deaths have occurred nationwide.
HAV is highly transmissible from person-to-person. States experiencing large-scale outbreaks have reported widespread transmission soon after their jurisdictions first recognized hepatitis A cases among populations being affected by these outbreaks. For many states, this has resulted in an unprecedented number of hepatitis A cases among unvaccinated adults since hepatitis A vaccine became available in 1996 and has led to prolonged community outbreaks that have been challenging and costly to control.
CDC recommends that public health departments, healthcare providers, and other partners serving affected populations launch a rapid and effective public health response. As of November 2, 2018, ACIP recommends hepatitis A vaccine for post-exposure prophylaxis (PEP) for people 12 months of age and older. Providers may also administer immunoglobulin to adults older than 40 years of age, if indicated, and persons who are immunocompromised or have chronic liver disease. As of February 15, 2019, ACIP recommends hepatitis A vaccination for people experiencing homelessness.
