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National hepatitis A outbreak mostly over in West, but continues in East

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The national hepatitis A outbreak has not yet burned out. Since 2016, 35 states have reported 38,476 hepatitis A cases. Through April 2, 2021, 61 percent or 23,373 of the stricken have required hospitalization, and 365 have died.

The Division of Viral Hepatitis at the federal Centers for Disease Control and Prevention (CDC) since 2017 has actively assisted state and local health departments with hepatitis A cases. Nine states, mostly in the West, have declared their Hepatitis A outbreaks as over.

Person-to-person transmission of hepatitis A remains a problem in 26 states. Several groups continue to be more likely than others to become infected with hepatitis A. These include:

  • People who use drugs, injection, and non-injection.
  • Homeless people or those who are experiencing unstable housing.
  • Men who have sex with men. (MSM)
  • People in jail or recently incarcerated.
  • People with chronic liver disease, including cirrhosis, hepatitis B or C.

Hepatitis A spread by contaminated food and water is possible, but that’s not a principal concern in the current national outbreak.

Hepatitis A is one of the common liver diseases. It inflames the vital organ that processes nutrients, filters the blood, and fights infections. While heavy drinking can damage the liver, a virus usually brings out Hep A.

And CDC recommends the Hep A vaccine as the best way to prevent HAV infection. A one-dose single-antigen hepatitis A. vaccine is proven to control Hepatitis A outbreaks.

States — all east of the Mississippi River — with the most hepatitis A cases include Kentucky (5,132), Florida (5,024), Ohio (3,720), and Tennessee (3036).

State and local health departments haven’t yet extinguished the outbreak in 26 Eastern states, including the big four. Two eastern states, West Virginia and Massachusetts have declared their Hep A outbreaks as over.

Arizona, California, Colorado, Idaho, Nevada, New Mexico, and Utah have declared an end to their outbreaks. In the West, only Kansas and Washington State continue to experience cases.

State-Reported Hepatitis A Outbreak Cases as of April 2, 2021

Data illustrated in this map can be found in the table found directly below

State-Reported Hepatitis A Outbreak Cases and Clinical Outcomes

State Case Total Hospitalizations n (%) Deaths Outbreak Start Date Data Current Through
Total (35 states) 38476 23373 (61%) 365
States with an ongoing outbreak(n=26)
Alabama 1177 812 (69%) NR 9/1/2018 12/31/2020
Arkansas 482 256 (53%) 3 2/7/2018 3/6/2020
Delaware 38 28 (74%) 1 8/1/2019 1/22/2021
Florida 5024 3417 (68%) 76 1/1/2018 2/28/2021
Georgia 1622 1038 (64%) 8 6/1/2018 3/27/2021
Illinois 211 141 (67%) 1 9/1/2018 10/1/2020
Indiana 2471 1376 (56%) 4 11/1/2017 11/25/2020
Kansas 343 285 (83%) 3 5/15/2020 2/12/2021
Kentucky 5132 2449 (48%) 64 8/1/2017 2/25/2021
Louisiana 1533 904 (59%) 7 1/1/2018 3/18/2021
Maryland 370 264 (71%) 4 12/1/2019 4/1/2021
Michigan 920 738 (80%) 30 8/1/2016 2/5/2020
Minnesota 128 89 (70%) 1 12/16/2018 3/26/2021
Mississippi 187 129 (69%) 0 4/1/2019 2/26/2020
Missouri 697 403 (58%) 2 9/1/2017 3/14/2020
New Hampshire 319 198 (62%) 2 11/1/2018 2/11/2020
New Jersey 777 397 (51%) 11 12/1/2018 3/2/2021
New York (excluding New York City) 482 322 (67%) 0 6/1/2019 3/27/2021
North Carolina 482 300 (62%) 5 1/1/2018 1/23/2021
Ohio 3720 2317 (62%) 16 1/1/2018 3/29/2021
Pennsylvania 886 678 (77%) 15 1/1/2018 3/27/2021
South Carolina 1911 992 (52%) 8 11/1/2018 1/22/2021
Tennessee 3036 1839 (61%) 28 12/1/2017 5/8/2020
Vermont 34 19 (56%) 0 1/1/2019 2/27/2021
Virginia 476 295 (62%) 2 1/1/2019 3/25/2021
Washington 366 212 (58%) 5 4/1/2019 6/22/2020
States with a declared end to their outbreak (n=9)
Arizona 598 484 (81%) 8 11/1/2018 4/16/2020
California 708 464 (66%) 21 11/1/2016 4/11/2018
Colorado 418 296 (71%) 2 10/1/2018 2/1/2021
Idaho 77 39 (51%) 0 1/1/2019 11/1/2020
Massachusetts 563 442 (79%) 9 4/1/2018 5/29/2020
Nevada 107 94 (88%) 1 11/1/2018 6/18/2020
New Mexico 168 127 (76%) 2 11/8/2018 6/10/2020
Utah 281 152 (54%) 3 5/8/2017 2/12/2019
West Virginia 2732 1377 (50%) 23 3/19/2018 8/24/2020

NR: not publicly reported

  1. “Outbreak-associated” status is currently determined at the state level in accordance with each state’s respective outbreak case definition.
  2. Outbreak-related hepatitis A deaths are defined at the state level in accordance with each state’s respective hepatitis A-related death definition. Some states are reviewing death certificates on a regular basis to actively find hepatitis A-related deaths, while other states are utilizing passive surveillance.
  3. Outbreak start date is defined at the state level and may represent the earliest onset date of an outbreak case (AR, AZ, KS, UT), the left censor date for which cases are considered part of the outbreak based on the state outbreak case definition (AL, CA, CO, DE, FL, GA, ID, IL, IN, KY, LA, MD, MA, MI, MN, MO, MS, NV, NH, NJ, NC, OH, PA, SC, TN, VA, WA), or when a state declared a hepatitis A outbreak (NM, WV).

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Source: https://www.foodsafetynews.com/2021/04/national-hepatitis-a-outbreak-mostly-over-in-west-but-continues-in-east/


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