CDC Issues Updated Advisory Regarding Outbreaks of Hepatitis A

The CDC has issued guidelines to assist clinicians in identifying and preventing new infections
The CDC has issued guidelines to assist clinicians in identifying and preventing new infections

The Centers for Disease Control and Prevention (CDC) has issued a Health Alert Network Advisory regarding outbreaks of hepatitis A infection among individuals reporting drug use and/or homelessness. 

Of the 2500 cases of hepatitis A infection reported between January 2017 and April 2018, 68% were among persons who reported drug use (injection and non-injection), homelessness, or both. In response to these outbreaks, the CDC has issued guidelines to assist clinicians in identifying and preventing new infections. These include: 

  • Consider hepatitis A as a diagnosis in anyone with jaundice and clinically compatible symptoms. 
  • Encourage persons who have been exposed recently to hepatitis A virus and who have not been vaccinated to be administered 1 dose of single-antigen hepatitis A vaccine or immune globulin (IG) as soon as possible, within 2 weeks after exposure. 
  • Consider saving serum samples for additional testing to assist in the investigation of transmission.
  • Ensure all persons diagnosed with hepatitis A are reported to the health department in a timely manner.
  • Encourage hepatitis A vaccination for homeless persons in areas where hepatitis A outbreaks are occurring.
  • Encourage hepatitis A vaccination for persons who report drug use or other risk factors for hepatitis A.

An infected individual can be viremic up to 6 weeks through their clinical course and excrete virus in stool for up to 2 weeks prior to becoming symptomatic. Symptoms may include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain, and jaundice.

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Vaccination against hepatitis A is recommended for all children at age 1 and for individuals at increased risk for infection. Vaccines currently licensed in the US are the single-antigen vaccines Havrix (GlaxoSmithKline) and Vaqta (Merck) and the combination vaccine Twinrix (GlaxoSmithKline); GamaSTAN S/D (Grifols Therapeutics) IG is approved for hepatitis A virus prophylaxis.  

For more information visit CDC.gov.