This increase is concerning for the beginnings of an outbreak–New Hampshire Department of Health and Human Services (DPHS)

New Hampshire state health officials are reporting a significant increase in the number of hepatitis A cases.

Over the past three months, 13 new individuals have been diagnosed with acute hepatitis A infections, including 7 in January, compared to an average of 6 – 7 people annually (range of 1-10 cases annually) over the past five years. The cases occurred in residents residing the southern part of the state.

“There are large outbreaks of hepatitis A occurring in multiple other states across the country,” said Dr. Benjamin Chan, NH State Epidemiologist. “While these outbreaks have often started in individuals experiencing homelessness and those with a substance use disorder, once it is in our communities it can spread very easily even to others without specific risk factors. Thankfully, hepatitis A is a vaccine-preventable disease. We encourage anybody who wishes to protect themselves from hepatitis A to talk with their healthcare provider about obtaining the very effective hepatitis A vaccine.”


DPHS reports the hepatitis A virus (HAV) is contagious and is transmitted when a person ingests the virus from objects, food or drinks contaminated by small, undetected amounts of stool from an infected person. The virus can survive for months on surfaces. People at risk of contracting the virus are:

  • persons experiencing homelessness
  • persons using injection or non-injection recreational drugs, including marijuana
  • people experiencing homelessness or with unstable housing (e.g. “couch surfing”)
  • gay and bisexual men
  • people with ongoing, close contact with individuals who use injection and non-injection drugs, or with individuals
  • experiencing homelessness
  • close contacts of individuals diagnosed with hepatitis A
  • travelers to countries with high rates of the virus

Hepatitis A causes inflammation of the liver; severe infections can result in liver failure and even death. Symptoms include fever, tiredness, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain, and jaundice (yellowing of the skin and eyes). These symptoms can last weeks to months and there is no specific treatment for hepatitis A. Hepatitis A is preventable and the vaccination is safe and effective. The vaccine is recommended for:

  • Hepatitis A Vaccine Image/National Institute of Diabetes and Digestive and Kidney Diseases
    Hepatitis A Vaccine
    Image/National Institute of Diabetes and Digestive and Kidney Diseases

    all children starting at one year of age and older

  • people who are at increased risk of hepatitis A infection (as noted above)
  • those with chronic liver diseases (such as hepatitis B and hepatitis C infections)
  • anybody wishing to obtain immunity