The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) has identified three cases of hepatitis A virus (HAV) infection since December 2018 in individuals who were experiencing homelessness or who were using drugs.
Public health is advising providers that all persons experiencing homelessness or using drugs should receive hepatitis A vaccine in accordance with the recently updated national guidelines.
18 states have reported HAV outbreaks among persons experiencing homelessness or using drugs.
Although an outbreak is not currently occurring in NYC, DOHMH and the NYC Department of Homeless Services (DHS) are working together to ensure that these New Yorkers are safe, by increasing efforts to offer preventive hepatitis A vaccinations to avoid a similar occurrence in the city.
Hepatitis A is a highly contagious liver infection caused by HAV, ranging in severity from mild infection lasting a few weeks to severe disease lasting several months. While most patients will fully recover, hospitalizations for cases in the recent nationwide HAV outbreaks among people who are homeless or use drugs have ranged from 25%–82%, and case mortality in these outbreaks has been 3%. This is likely related to the higher than average prevalence of comorbidities including other liver diseases in many persons experiencing homelessness.
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