Hepatitis A
At a Glance
Philadelphia Hepatitis A Activity (last updated March 6, 2020) - 450 confirmed cases - 445 of which were outbreak-related.
Philadelphia Hepatitis A Vaccination (last updated March 6, 2020) - 9,581 total vaccinations administered by PDPH.
- 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.
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).
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.
National and State Hepatitis A Surveillance Updates: Pennsylvania, New Jersey, and CDC
Vaccine Information
- 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.
- Recommend HAV control and prevention measures for cases:
- Offer VAC 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 harm reduction practices while contagious (1 week after jaundice onset or if no jaundice, 2 weeks after illness onset).
Diagnosis & 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.
- 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 an opportunity for questions. Click here to view a PDF version of the webinar slides.
For Patients and Community Members:
There are no patient or community resources for Hepatitis A.
Posters:
There are no posters for Hepatitis A.