CDC Warns of Multi-State Hep A Outbreak

June 12, 2018

The CDC has warned of outbreaks in multiple states of hepatitis A infection among individuals who use drugs or who are homeless.

Over 2500 reports of hepatitis A infection related to person-to-person transmission were reported from January 2017 to April 2018 in multiple states. Risk factors were known in more than 1900 reports, of which more than 1300 were associated with injection and non-injection drug use and homelessness, or both. Responses to these outbreaks were associated with an increase in vaccine demand in certain states, although vaccine supply has been increased and is now more readily available.


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States reporting such outbreaks include California, Indiana, Kentucky, Michigan, Missouri, Utah, and West Virginia.

The CDC has issued the following recommendations to clinicians:

  • Hepatitis A should be considered in anyone with jaundice and clinically compatible symptoms.
  • Encourage those exposed to the virus and who have not been vaccinated to receive 1 dose of single-antigen vaccine or immune globulin within 2 weeks of exposure.
  • Save serum samples for additional testing.
  • Report all diagnoses to the health department.
  • Encourage vaccination for homeless individuals and for those who report drug use.

“Rapid identification, a comprehensive response, and novel public health approaches may be required to address needs unique to these populations. Urgent action is needed to prevent further hepatitis A virus transmission among these risk groups.”

—Michael Potts


Outbreak of hepatitis A virus (HAV) infections among persons who use drugs and persons experiencing homelessness [press release]. June 11, 2018. https://emergency.cdc.gov/han/han00412.asp.