Hepatitis A Person-to-Person Outbreaks: Epidemiology, Morbidity Burden, and Factors Associated With Hospitalization—Multiple States, 2016–2019

Abstract

Background Since 2016, the US has experienced person-to-person hepatitis A outbreaks unprecedented in the vaccine era. The proportion of cases hospitalized in these outbreaks exceeds historical national surveillance data. Methods We described the epidemiology, characterized the reported increased morbidity, and identified factors associated with hospitalization during the outbreaks by reviewing a 10% random sample of outbreak-associated hepatitis A cases in Kentucky, Michigan, and West Virginia–three heavily affected states. We calculated descriptive statistics and conducted age-adjusted log-binomial regression analyses to identify factors associated with hospitalization. Results Participants in the random sample (n=817) were primarily male (62.5%) with mean age of 39.0 years; 51.8% were hospitalized. Among those with available information, 73.2% reported drug use, 14.0% were experiencing homelessness, 29.7% were currently or recently incarcerated, and 61.6% were epidemiologically linked to a known outbreak-associated case. Residence in Michigan (adjusted risk ratio [aRR] 1.8), being a man who has sex with men (aRR 1.5), non-injection drug use (aRR 1.3), and homelessness (aRR 1.3) were significantly (p<0.05) associated with hepatitis A-related hospitalization. Conclusions Our findings support current Advisory Committee on Immunization Practices recommendations to vaccinate all persons who use drugs, men who have sex with men, and persons experiencing homelessness against hepatitis A.

Low Prevalence of Vaccination or Documented Immunity to Hepatitis A and Hepatitis B Viruses Among Individuals with Chronic Liver Disease

“…5,6 Increasing rates of hepatitis A infections and related outbreaks observed in the United States emphasize the importance of effective vaccination programs, particularly among individuals with greater behavioral and socioeconomic risk factors such as homelessness, injection drug use, and unsafe sex practices. 23 Our study adds to existing literature highlighting low rates of hepatitis A immunity or vaccination in patients with chronic viral hepatitis infections, 10,13,15,16 and further contributes new data reporting similarly low rates in nonalcoholic fatty liver disease and alcoholic liver disease patients. Using the 2014-2015 National Health Interview Survey, self-reported rates of completing hepatitis A and hepatitis B vaccination among adults with chronic liver disease was 11.5% and 29.1%, respectively.…”

Occupational exposures and mitigation strategies among homeless shelter workers at risk of COVID-19

“…Homeless shelters have previously experienced outbreaks such as tuberculosis, hepatitis A and invasive bacterial disease. [16][17][18][19] Control measures have primarily focused on controlling the outbreak among the client population rather than shelter workers. In a study of occupational exposures to infectious agents, an estimated 32.4% of community and social services sector workers are exposed > 1 time/month to infection or disease; 7.7% are estimated to be exposed > 1 time/week.…”

Deskripsi Kejadian Luar Biasa Hepatitis A di Kabupaten Pacitan Provinsi Jawa Timur

“…Beban penyakit yang tinggi, sekitar 1 dari 10 orang penduduk Kanada sudah terinfeksi pada saat usia 24-29 tahun. Hasil penelitian lain dari Hofmeister, M.G., et al (2020) juga menemukan bahwa kasus Hepatitis A paling banyak dialami kelompok usia 30-39 tahun (12). Peningkatan prevalensi pada orang dewasa muda bertepatan dengan impor penyakit dan meningkatkan frekuensi faktor risiko, yang berhubungan dengan perilaku.…”