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CDC Reports Explosive and Widespread Increase In Hepatitis A Cases In Specific Population Subgroups

Urgent Control Measures Called For

An official Health Update from the Centers for Disease Control and Prevention in late March 2019 reports more than 15,000 hepatitis A cases have occurred since 2016 when outbreaks in specific groups of persons were first identified. The outbreaks are now occurring primarily among people who use drugs (injection or non-injection) and people experiencing homelessness.

The more than 15,000 cases compares with 4,410 in the three year period 2013-2015  before the outbreaks, an almost fourfold increase since 2016.

In addition, CDC  reports 8,500 hospitalizations, or 57% of cases, a rate higher than in the past. To date, 140 deaths have been reported.

Previous outbreaks in 2012-2013 went from 1,562 to 1,781 cases and in 2015-2016 from 1,390 to 2,007. The 15,000 cases since 2016 clearly represents a new phenomenon not seen at least since 2000. Furthermore, CDC estimates that the actual number of acute cases may be twice as large as the reported number making the total cases in this ongoing outbreak approximately 30,000.

No large outbreaks among drug users have been seen in the US since vaccination with hepatitis A was recommended for this group in 1996. While outbreaks in homeless populations have been reported in other countries, according to CDC, no large outbreaks in his population have been reported previously in the US.

At least 18 states are experiencing this widespread outbreak. According to CDC, “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.”

Control Measures


Recommended control measures for health departments include:

·       Vaccination for high risk groups such as people who use drugs, homeless persons, men who have sex with men, people who are or were recently in prison, and people with chronic liver disease.

·       Outreach to providers who serve these populations

·        Case investigation, contract tracing, and outbreak response monitoring

Vigilance and preparation for mobilizing  in states not now experiencing cases in these high risk populations.

States reporting outbreaks in the latest health advisory report include:

  • Arkansas
     
  • California
     
  • Florida
     
  • Georgia
     
  • Illinois
     
  • Indiana
     
  • Michigan
     
  • Kentucky
     
  • Louisiana
     
  • Massachusetts
     
  • Missouri
     
  • New Hampshire
     
  • New Mexico
     
  • North Carolina
     
  • Ohio
     
  • Tennessee
     
  • Utah
     
  • West Virginia        ■

 


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