Hepatitis A Outbreaks in the United States

Measles isn’t the only vaccine-preventable disease making the news in the United States lately. Hepatitis A has been resurging in the last few years partly because of the opioid epidemic. As people share needles or engage in other risky behavior, the hepatitis A virus has been traveling throughout the country.

In Ohio has been battling an epidemic of hepatitis A since June of 2018, with over 2,200 cases reported so far. Recently, the state government approved additional funds for counties to combat the epidemic. Most of these funds will go toward hepatitis A vaccination clinics for people at risk.

In Kentucky, the statewide epidemic has been going on since 2017, with cases topping the ten-year average for the state. While there have been outbreaks there associated with food handlers, many of the cases are — like in other states — associated with intravenous drug use and homelessness. As a result, the state health authorities are recommending that everyone get the hepatitis A vaccine, not just those at high risk for contracting the disease.kentucky hepatitis statistics

In Pennsylvania, almost 200 cases since 2018 have prompted the Commonwealth’s Secretary of Health to declare the existence of an outbreak in order to secure more funds. As with Ohio and Kentucky, most of those funds are expected to go toward vaccination. It should be noted that 40 of the cases have been detected in the Philadelphia area.

There have also been cases reported in Martin County, Florida; Aroostook County, Maine (from a food handler); Sarasota, Florida (from a food handler); Lexington County, South Carolina, and other locations.

Hepatitis A is a viral infection transmitted primarily through the fecal-oral route. Other routes of transmission include sexual intercourse and sharing of dirty needles. Symptoms of the disease begin between 2 and 7 weeks after infection. The symptoms include a flu-like illness and jaundice, though many people infected don’t show symptoms, especially children. Nevertheless, people with preexisting conditions may be at risk for severe complications from hepatitis A.

The good news? The vaccine is safe and effective, and it has been given to children in the United States since 1995, triggering a precipitous drop in the number of cases in the United States. The vaccine is recommended for all children and for people at high risk of contracting the disease, especially those who could easily transmit it to others (e.g. food handlers, sex workers, and intravenous drug users).

Author: René F. Najera, DrPH

I am the editor of the History of Vaccines site, an online project by the College of Physicians of Philadelphia. All opinions expressed on these blog posts are not necessarily those of the College or any of my employers. Check out my professional profile on LinkedIn: https://www.linkedin.com/in/renenajera Feel free to follow me on Twitter: @EpiRen