10 reports on hepatitis A outbreaks, prevention from 2017
In 2017, researchers and physicians observed multiple outbreaks of hepatitis A throughout the United States and Europe, and they have been following an ongoing epidemic in Taiwan. They noted that in the U.S. and Europe, the outbreaks have heavily affected men who have sex with men.
The following reports cover details on the specific outbreaks and their correlated geography and demographics. Additionally, several of the following reports discuss management of HAV outbreaks, prevention education, and Alaska’s impressive vaccination program that has nearly eliminated HAV among all age groups.
Hepatitis A vaccines effective in high-risk populations during outbreak
Two-dose hepatitis A vaccination was an effective preventive measure among HIV-positive individuals, including a high study population of men who have sex with men, during an ongoing outbreak of acute HCV, according to recently published data.
“We found that HAV vaccination was highly effective in preventing acute HAV infection during the outbreak, despite the delayed serologic response among HIV-positive individuals,” Kuan-Yin Lin, MD, from the National Taiwan University Hospital, and colleagues wrote. “Our results support HAV serologic screening and vaccination for those at-risk HIV-positive populations in the era of [combination antiretroviral therapy] scale-up.” Read more
Hepatitis A outbreaks in Europe mostly affect men who have sex with men
The European Center for Disease Prevention and Control advised that hepatitis A outbreaks have been spreading across Europe, with most cases reported among unvaccinated men who have sex with men. The ECDC provided recommendations for awareness and prevention, as reported in a rapid risk assessment published Feb. 23, 2017.
“As suggested in our latest rapid risk assessment, further transmission may be prevented by vaccination of men who have sex with men and post-exposure prophylaxis among contacts of those infected,” Andrea Ammon, ECDC acting director, said in a press release. “Limited vaccine availability in some countries may however have an impact on the implementation of such control measures.” Read more
Alaskan vaccination program nearly eliminates Hepatitis A
Universal vaccination has nearly eliminated hepatitis A among all age groups in Alaska, according to a study presented at the World Indigenous Peoples’ Conference on Viral Hepatitis.
“Dramatic declines in the incidence of hepatitis A occurred after HAV vaccine was recommended as a routine childhood vaccine and after it was required for school entry,” the researchers reported in a press release. “Prior to routine vaccination, most [of] the reported HAV cases were associated with outbreaks occurring within Alaska. Since 2008 however, 88% of reported hepatitis A cases have been imported, many of which were acquired during travel outside of the United States.” Read more
California declares state of emergency over hepatitis A outbreak
California Governor Edmund G. Brown Jr. declared a state of emergency today to increase the number of adult hepatitis A vaccines needed to contain the state’s ongoing epidemic.
According to Gil Chavez, MD, MPH, deputy director and state epidemiologist at the California Department of Public Health (CDPH) Center for Infectious Diseases, the outbreak is currently affecting San Diego, Santa Cruz and Los Angeles counties. Local health emergencies were previously declared in San Diego on Sept. 1 and in Los Angeles on Sept. 19. Read more
San Diego officials declare hepatitis A outbreak a local health emergency
Officials in San Diego are increasing their efforts to mitigate an ongoing hepatitis A outbreak that was recently declared a local health emergency. Nearly 400 illnesses and 15 deaths were linked to the outbreak as of Sept. 5, according to San Diego’s Health and Human Services Agency. Seventy percent of the cases required hospitalization.
The outbreak is being spread through person-to-person transmission, largely affecting people who are homeless or report illicit drug use or both. The California Department of Public Health recently reported that it is the state’s largest hepatitis A outbreak in 2 decades. Read more
Thousands of 7-Eleven customers in Utah possibly exposed to hepatitis A
The Salt Lake County Health Department has reported that an employee of a 7-Eleven store in West Jordan, Utah, may have exposed as many as 2,000 customers to hepatitis A virus.
Customers with potential exposure include those who visited the store from Dec. 26 to Jan. 3 and used any restroom or consumed a self-serve beverage, fresh fruit or items from the store’s hot case, such as pizza, hot dogs, chicken wings or taquitos. Health officials are urging these customers to call the Salt Lake County Health Department (SLCoHD) for information about receiving a prophylactic hepatitis A vaccine. Those who consumed packaged items only, including bottled beverages and microwaved foods, as well as those who are fully vaccinated against hepatitis A, are not required to contact the health department. Read more
Hepatitis A increase in NYC linked to travel among MSM
According to the CDC, the New York City Department of Health and Mental Hygiene reported an increase in hepatitis A infection among men who have sex with men in the city this year. Further, some of these men report traveling to areas in Western Europe where HAV outbreaks are ongoing among MSM.
Between Jan. 1, and Aug. 31, 2017, the Department of Health and Mental Hygiene (DOHMH) identified 51 patients with HAV linked to the increase in New York City and with a history of sexual contact with MSM. Read more
California health officials battle state’s largest hepatitis A outbreak in 2 decades
The California Department of Public Health is working with local health officials in San Diego and Santa Cruz counties to contain the state’s largest hepatitis A outbreak in 2 decades.
As of July 18, officials identified 251 cases and five deaths in San Diego, and 27 cases in Santa Cruz since the outbreak began in November, according to the California Department of Public Health (CDPH). San Diego’s Health and Human Services Agency reported that 69% of cases in the county required hospitalization. Read more
San Diego manages hepatitis A outbreak with outreach, education
During the last year, San Diego County experienced an outbreak of hepatitis A totaling 481 confirmed and probable cases, according to a presentation at IDWeek 2017. Members of the county’s health care agencies and the CDC implemented strategies to identify risk factors, provide vaccinations, and increase education among those at the highest risk for transmission.
“It’s not unusual for large person-to-person hepatitis A virus outbreaks to last quite some time — between 1 to 2 years — but the key is to decrease the population that’s susceptible to infection and that’s done through vaccination,” Monique Foster, MD, MPH, division of viral hepatitis at the Centers for Disease Control and Prevention, said in the presentation. “We also want to mitigate their risk exposure through good hand hygiene and access to clean public restrooms.” Read more
Most immune globulin products ineffective for hepatitis A prophylaxis
A recent letter published in JAMA Internal Medicine reports two of nine human immune globulin products tested for hepatitis A prophylaxis efficacy just meet the minimal potency level required by the European Pharmacopeia.
“Because anti-HAV antibody levels are declining in plasma donors from developing countries, we evaluated antibody levels in currently marketed [immune globulin (IG)] products,” Alexandra Tejada-Strop, MS, from the division of viral hepatitis at CDC, and colleagues wrote. “Several products had lower-than-expected anti-HAV potencies, potentially conferring protection of reduced magnitude of duration against hepatitis A.” Read more