Hepatitis A Outbreak in Philadelphia
Philadelphia Hepatitis A Activity:      Number of Outbreak-Related Cases (2019-2020): 438* Number of All Confirmed Cases (2019-2020): 443* *Year-to-date Last Updated (02/14/2020)	Philadelphia Hepatitis A Vaccination: Total Number of Vaccinations Provided by PDPH: 9,429* *All reported vaccine doses given by PDPH to date Last Updated (02/14/2020)
Current Recommendations Providers should offer HAV vaccine at every opportunity. See below for additional recommendations. Case Reporting: Promptly report acute HAV cases to PDPH by calling 215-685-6740 (after-hours: call 215-686-4514).
Latest Updates on Hepatitis A On August 1, 2019, Philadelphia declared a public health emergency in response to continuing rapid increases in hepatitis A virus (HAV) infections among persons who use drugs and those who are living homeless. On January 23, 2020, the Division of Disease Control released a Hepatitis A Outbreak Response Update Report detailing the Department's response strategies and recommendations for sustained outbreak control.

Health Alerts, Advisories, Notifications, and Updates

---

• PDPH Alert - Public Health Emergency Update: Hepatitis A Outbreak among At-Risk People in Philadelphia (Released: 01/09/2020)  
• PDPH Alert - Public Health Emergency Update: Hepatitis A Outbreak (Released: 10/18/2019) 
• PDPH Alert - Public Health Emergency: Hepatitis A Outbreak among At-Risk People in Philadelphia (Released: 08/08/2019)
• PDPH Alert - Rapid Increases in Hep A among People Who Use Drugs in Philadelphia: Expanding Efforts to Provide Hep A Vaccination to At-Risk Persons (Released: 07/19/2019)
• PDPH Alert - Ongoing Increases in Philadelphia: Recommendations for Prevention and Control through Vaccination (Released: 05/31/2019)
• PADOH - Department of Health Declares Hepatitis A Outbreak (Released: 05/20/2019)
• PDPH Alert - Hepatitis A, Ongoing Increases in Philadelphia: Recommendations for Diagnosis, Control, and Prevention (Released: 04/11/2019)
• PDPH Alert - Hepatitis A Outbreak in Pennsylvania: Increase Vaccination of High Risk Patients to Prevent and Control Transmission in Philadelphia (Released: 11/29/2018)

Stay informed about future alerts and notifications by registering for the Health Alert Network.

Surveillance

---

Hepatitis A outbreaks are ongoing in Philadelphia and several U.S. states. The majority of cases are among persons who use drugs and those who are living homeless, but cases are also occurring among persons with no known risk factors.

Philadelphia Hepatitis A Surveillance Updates: Coming Soon!

National and State Hepatitis A Surveillance Updates:

Pennsylvania

CDC

New Jersey

Recommendations for Vaccination and Other Prevention Strategies

---

• Offer HAV vaccine at every opportunity to patients most at-risk for HAV vaccination or serious complications from HAV including:
  • People who use injection or non-injection drugs
  • People experiencing homelessness or unstable housing
  • People who are or were recently incarcerated
  • Men who have sex with men (MSM)
  • People with chronic liver disease (cirrhosis, hepatitis B, or hepatitis C)
  • People with HIV (New Advisory Committee on Immunization Practices' Recommendation)
• Where to Get Vaccine: 
  • For people who are insured, click here for maps of pharmacies in Philadelphia where Hep A vaccine is currently available. 
  • For people who are uninsured, click here for a list of clinics who have Hep A vaccine.

• Recommend HAV control and prevention measures for cases:
  
  • Offer HAV vaccine to susceptible, close contacts of cases (e.g., household members, sex partners, persons who shared drugs with the case). Guidance for use of post-exposure vaccine is available here.
  • Advise HAV cases to take other steps to prevent transmission, such as hand washing, avoiding food preparation for others, condom use, and hard reduction practices while contagious (1 week after jaundice onset or if no jaundice, 2 weeks after illness onset).

Diagnosis and Management

---

• Acute HAV infection is confirmed during the acute or early convalescent phase of infection by the presence of anti-HAV IgM in serum. Clinicians who suspect acute HAV infection should also order liver function tests. Total antibody testing alone is not adequate for the diagnosis of acute hepatitis A infection.
• There is no treatment other than supportive care.
• Case Reporting: Promptly report acute HAV cases to PDPH by calling 215-685-6740 (after-hours: call 215-686-4514).

 

Resources

---

For Healthcare Providers:

• Hepatitis A Vaccine Information Statement
• Hepatitis A Recommendations
  • CDC Prevention of Hepatitis A Through Active or Passive Immunization [MMWR, May 19, 2006 / 55 (RR07):1-23]
  • CDC Update: Recommendations of the Advisory Committee on Immunization Practices for Use of Hepatitis A Vaccine for Post-Exposure Prophylaxis and for Pre-Exposure Prophylaxis for International Travel [MMWR, November 2, 2018 / 67(43):1216-1220]

• Hepatitis A Outbreak Webinar - Updates and Actions: Additionally, the Division of Disease Control hosted three webinars to review the outbreak in Philadelphia, describe health department actions to control the outbreak, and provide and opportunity for questions. Click here to view the PDF version of the webinar slides.

For Patients and Community Members:

 

 

Hep A Flyer for Men Who Have Sex with Men (MSM)

Hep A Palm Cards

Hep A FAQs

 

Hep A Clean-Up and Prevention