The number of states battling hepatitis A outbreaks has risen to 20, with the addition of Colorado and Virginia in the past month.

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Since these outbreaks were first identified in 2016, more than 15,000 cases and 8,500 hospitalizations (57% of cases) have been reported in the United States.

In Virginia, health officials have recently declared a hepatitis A virus (HAV) outbreak, saying they now meet the criteria to be considered an “outbreak state”.

Virginia has reported a 132 percent increase in cases of HAV between January 1, 2019 and April 19, 2019 compared to the same time period in 2018. There have been 45 cases reported in Virginia as of April 22, 2019. Of this total, more than half (25 cases) required hospitalization.

No deaths have been reported.

Cumberland Plateau (12) and Rappahannock Rapidan (6) health districts have seen the most cases.

“The increase in HAV cases in Virginia indicates that the Commonwealth is now experiencing the effects of this nationwide outbreak,” said State Health Commissioner M. Norman Oliver, MD, MA. “We want everyone to know how the infection is spread, be able to recognize the symptoms, and take actions to prevent the spread of hepatitis A.”

The classic symptom of HAV is jaundice, which is a yellowing of the skin or the eyes. Other symptoms include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, joint pain, dark urine and clay-colored stools. Symptoms develop 15-50 days after exposure to the virus. It is very important for people who have symptoms to stay home from work, especially if they work in food service, health care or child care.


Local health departments, in conjunction with community partners, are working to increase hepatitis A vaccination rates statewide. The efforts specifically focus on individuals who are members of high risk groups such as those who are/have recently been incarcerated, persons who are experiencing/recently experienced homelessness, injection and non-injection drug users, and men who have sex with men (MSM). Although the focus is on those at higher risk for infection, any Virginian who desires hepatitis A vaccine should receive it.