The New York City (NYC) Health Department has noted an increase in hepatitis A cases among men who have sex with men (MSM) who did not report international travel.
Typically, the NYC Health Department receives 0-3 reports of non-travel related hepatitis A cases in MSM. As of March 8, 2017, five cases of hepatitis A have been reported among unvaccinated MSM since January 1, 2017.
Patients resided in three of the five boroughs, and ranged in age from 27-47 years. Three of the five patients (60%) were hospitalized, and all patients have since recovered without complications.
Since 1996, the Advisory Committee on Immunization Practices (ACIP) has recommended that all MSM receive two doses of hepatitis A vaccine; the second dose should be administered 6-12 months after the first dose.
Repeated outbreaks of hepatitis A have occurred among MSM in urban areas in the United States, Canada, Australia, and Europe.
Hepatitis A is transmitted person-to-person through the fecal-oral/sexual route. Among MSM, Hepatitis A can be spread through direct anal-oral contact or contact with fingers or objects that have been in or near the anus of an infected person and contaminated with stool.
Hepatitis A can also be spread through contaminated food or water, which most often occurs in countries where Hepatitis A is common. While most patients will fully recover, 50% of adult patients in NYC with hepatitis A are hospitalized, and in the United States, hepatitis A is responsible for approximately 100 deaths annually.