Hepatitis A

Hepatitis A Outbreak Situation Update

Last updated: 11/30/2017

Outbreaks of hepatitis A are ongoing in San Diego, Santa Cruz and Los Angeles counties in persons who are homeless and/or using illicit drugs, as well as in several other states. With >660 cases to date in California alone, it has become the largest person-to-person (not related to a common source or contaminated food product) hepatitis A outbreak since the hepatitis A vaccine became available in 1996. As the use of adult hepatitis A vaccine has increased to help control these outbreaks, there is a national vaccine supply shortage and supply is expected to remain extremely limited through the end of 2017.

Commercial and public sector orders have temporarily diminished or ceased due to lack of supply. There is currently no shortage of pediatric vaccine or Twinrix®. In response to the adult hepatitis A vaccine shortage, California Department of Public Health (CDPH) declared a State of Emergency on 10/13. The State of Emergency allowed CDPH to acquire a reserve supply and assume control of all adult Hepatitis A vaccine supply.

Vaccine is being prioritized to areas of highest risk where there is ongoing local transmission or outbreak associated cases for outbreak containment.  Alameda County does not currently have local transmission of hepatitis A or outbreak associated cases, yet we have recently received a limited amount of vaccine that will be used solely to vaccinate those experiencing homelessness.  Vaccination efforts at tent encampments, shelters and soup kitchens will begin in early December.  This is a dynamic situation that could change at any moment. Please check this webpage or CDPH Hepatitis A Outbreak webpage regularly for updates.

What is Hepatitis A?

Hepatitis A is a vaccine-preventable contagious disease caused by the Hepatitis A virus. It causes acute inflammation of the liver (hepatitis means inflamed liver) and does not become a chronic condition unlike other Hepatitis infections such as B, C or D. After an individual is infected with Hepatitis A they cannot catch it again as the body develops antibodies to protect against future exposures.

Signs and symptoms may include:

  • Fatigue
  • Loss of appetite
  • Nausea
  • Vomiting
  • Abdominal pain
  • Dark urine
  • Clay-colored bowel movements
  • Joint pain
  • Jaundice (yellowing of skin or eyes)

How is Hepatitis A spread?

The hepatitis A virus is usually spread by putting something in your mouth that is contaminated by the stool (poop) of another person who is infected with hepatitis A.

Hepatitis A is contracted through:

  • household contact with an infected person
  • sexual contact with an infected person
  • eating or drinking contaminated food or water
  • sharing eating utensils that are contaminated
  • touching contaminated surfaces and then placing your hands near or in the mouth

What can I do to protect myself?

Immunization is the best protection

It is recommended that children 12 months through 18 years of age be given the two dose vaccine series. A single dose vaccine is effective protection for most healthy adults and is especially recommended for those travelling to an area where Hepatitis A is endemic.

Practice good hand hygiene

Because so many cases of hepatitis A are due to close contact with an infected person, you should always practice good personal hygiene. The simple act of washing your hands can protect you against Hepatitis A and other diseases.

What should I do if I think I have been exposed to Hepatitis A?

If you believe you were exposed to Hepatitis A contact your health care provider or local health department. If you were recently exposed to Hepatitis A virus and have not been vaccinated against it, an injection of Hepatitis A vaccine may be recommended and needs to be given within first two weeks after exposure to be effective. Consult with your health care provider to collaborate on making the best decision for you and your family.

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