The hepatitis A virus (HAV) situation in the United States among certain at-risk populations (homelessness, using illicit drugs) really got it’s start in mid- to late 2016 in Michigan and California.

 Hepatitis A is manifested here as icterus, or jaundice of the conjunctivae and facial skin/CDC
Hepatitis A is manifested here as icterus, or jaundice of the conjunctivae and facial skin/CDC

Since that time, the number of cases in these high-risk groups grew in numbers and spread to a number of states.

By the end of 2017, federal health officials reported more than 3,000 cases nationally. While not all cases were outbreak cases, a good number were. And the outbreak cases were not linked to tainted food.

Hepatitis C: A Complete Guide for Patients and Families (A Johns Hopkins Press Health Book)

We reported on the this outbreak since that time and saw state after state declare outbreaks–and some of these states have reported thousands of cases like Kentucky and West Virginia, for example. In addition, a high percentage of cases required hospitalization and dozens of fatalities were reported in outbreak cases, which is higher than usual.

10 Most Important Infectious Disease Stories of 2018: Outbreak News Today

How are the numbers in 2018?

According to the Centers for Disease Control and Prevention (CDC), some 10,582 cases were reported to the agency, more than three times what was seen in 2017.

After the introduction of hepatitis A vaccine in 1996, the incidence of reported HAV infection steadily decreased in the United States until 2011 and then stabilized at an annual average of approximately 1,600 reported cases, mostly among international travelers returning from countries with endemic HAV or as part of foodborne outbreaks

Of course this has prompted health officials at all levels to encourage and offer hepatitis A vaccination to individuals at highest risk of acquiring infection (e.g., people who use injection/non-injection drugs, men who have sex with men, homeless, people who have been recently incarcerated, and people with chronic liver disease).

The Advisory Committee on Immunization Practices (ACIP) recommends hepatitis A vaccination for the following people:

  • All children at age 1 year
  • Travelers to countries where hepatitis A is common
  • Family and caregivers of adoptees from countries where hepatitis A is common
  • Men who have sexual encounters with other men
  • Users of injection and non-injection drugs
  • Persons with chronic liver disease
  • Persons with clotting-factor disorders
  • Persons who work with HAV-infected primates or with HAV in a research laboratory setting
  • People with direct contact with others who have hepatitis A
  • Any person wishing to obtain immunity (protection)