Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus (HAV). It can range from a mild illness lasting a few weeks to a severe illness lasting several months.

Image/KDH
Image/KDH

The HAV outbreaks in all affected states among injection and non-injection drug users, homeless populations, and men who have sex with men (MSM). High hospitalization rates and some deaths have been reported.

Depending on state, the outbreak began in mid-August 2016 with 18 states reporting outbreaks to date. Here is the latest state-by-state data:

Arkansas

Since February 2018, 294 cases have been reported as part of this outbreak. The outbreak is heavily clustered in the northeast part of the state with Greene, Clay and Craighead counties reporting the most cases.

California

California experienced a large hepatitis A outbreak in 2017-2018 accounting for hundreds of cases, particularly in San Diego. The outbreak is now over.

Florida

Since Jan. 2018 through Feb, 2019, 971 cases have been reported, with 424 in just the first two months of 2019. Approximately 73 percent of the cases required hospitalization and five deaths were reported.

Georgia

Since January 2018, the Georgia Department of Public Health (DPH) has identified 170 acute hepatitis A virus (HAV) infections statewide (to date) – more than six times higher than the total of 24 infections identified in 2017. Nearly 60% of the infections have occurred in Northwest and North Georgia as well as the Augusta area.

66% of the identified HAV cases have been hospitalized.

Illinois

As of March 13, Illinois has reported 48 hepatitis A cases. 2/3s of the cases required hospitalization and 1/3 of the cases were from Edgar County.

Indiana

Since November 2017, the Indiana State Department of Health (ISDH) has been investigating an outbreak of acute hepatitis A virus (HAV).

As of Mar. 15, 1,124 HAV cases were reported including four deaths. More than half the cases required hospitalization with Wayne and Marion Counties reporting the most.

Kentucky

In November 2017, the Kentucky Department for Public Health (DPH) identified an outbreak of acute hepatitis A.

Since then, 4,288 cases were reported as of Mar. 2, the most in the country. In addition more than 2,000 people required hospitalization and 44 people died.

Louisiana

Health officials in Louisiana declared an outbreak last December. 74 outbreak cases have been reported as of Feb. 22 and seven out of 10 people required hospitalization.

Morehouse Parish has been hit hardest by the outbreak.

Massachusetts

Since April 2018, 331 cases of acute hepatitis A virus (HAV) infection have been reported to the Massachusetts Department of Public Health (MDPH) in individuals with recent experience of homelessness, unstable housing, and/or substance use disorder.

82 percent of cases required hospitalization and five deaths were reported. Half of the outbreak cases are from two counties: Suffolk and Worcester.

Michigan

The outbreak in Michigan started in August 2016. Through Wednesday, 913 cases and 28 deaths have been reported. 80 percent required hospitalization.

Missouri

Since September 2017, the Missouri Department of Health and Local Public Health Agencies (LPHAs) have received increased reports of hepatitis A linked to an ongoing outbreak in Missouri.  As of Mar. 11, 2019, 269 cases of hepatitis A virus infection have been linked to the outbreak. One death has been recorded. Butler County has seen 107 of the outbreak cases.

New Hampshire

One of the newer outbreaks, New Hampshire has reported 44 outbreak cases from Nov. 1- Mar. 12. Nearly half the cases are from Hillsborough County.

New Mexico

In November, health officials reported a small outbreak in Bernalillo County.

North Carolina

NC health officials have reported 73 HAV outbreak cases through Mar.11. One death was recorded and 73 percent of patients required hospitalization.

Ohio

The Ohio Department of Health (ODH) declared a statewide community outbreak of hepatitis A after observing an increase in cases linked to certain risk factors since the beginning of 2018.

As of Mar. 11, 2019, 1,931 cases and seven deaths have been reported. Franklin, Butler and Montgomery counties have all recorded more than 200 cases each.

Tennessee

Health officials have reported 1,022 HAV outbreak cases, including six fatalities. The Mid-Cumberland, Nashville and Chattanooga regions have seen the most cases.

Utah

Since January 1, 2017, Utah public health has identified 281 confirmed outbreak cases of hepatitis A virus (HAV) infection. Two deaths have been reported in Salt Lake County.

West Virginia

Since March 2018, the West Virginia Bureau for Public Health has reported an increase in the number of confirmed cases of acute hepatitis A virus. This increase in cases has primarily been among injection and non-injection drug users, homeless or mobile individuals, and those who have been recently incarcerated. Viral sequencing has linked cases from Kentucky and California.

As of Mar. 15, 2,441 HAV outbreak cases have been reported, including 21 deaths.

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