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Hepatitis A

At a Glance

  • 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.
  • On February, 20, 2024, the Health Department issued a Health Alert regarding Hepatitis A increases among at-risk persons in Philadelphia.

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).
Topic Priority Date of Alert
Hepatitis A Increases among At-Risk Persons in Philadelphia: Recommendations for Prevention and Control through Vaccination Alert Feb 20, 2024
Hepatitis A in Philadelphia: Updates on Recent Increases and the National Frozen Strawberry Recall Alert Jun 26, 2023
Hepatitis A Increases among At-Risk Persons in Philadelphia Alert Mar 28, 2023
Hepatitis A Increases among At-Risk Persons in Philadelphia: Recommendations for Prevention and Control through Vaccination Alert Aug 6, 2021
Public Health Emergency Update: Hepatitis A Outbreak among At-Risk People in Philadelphia Alert Jan 9, 2020

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)
  • Vaccine information:
    • One dose of single-antigen HAV vaccine leads to a protective response in 95% of healthy individuals for up to 11 years. Two doses given at least 6 months apart provide long-lasting immunity.
    • Vaccines for Children (VFC) and Vaccines for Adults at Risk (VFAAR) providers should continue to order HAV vaccine through the PhilaVax inventory module. If your facility does not have HAV vaccine, please encourage patients to visit a pharmacy if they have insurance. Patients should call ahead to make sure that the pharmacy has HAV vaccine.
    • If you have questions about accessing vaccine for adults, contact the Immunization Program at vaccines@phila.gov.
  • 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:

For Patients and Community Members:

There are no patient or community resources for Hepatitis A.

Posters:

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