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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