Joint Hepatitis A Outbreak Prevention Advisory

Alameda County Public Health and Berkeley Public Health
Joint Hepatitis A Outbreak Prevention Advisory

Outbreaks of hepatitis A are currently ongoing in San Diego, Santa Cruz and Los Angeles counties in persons who are homeless and/or using illicit drugs. The outbreak in San Diego is the largest person-to-person hepatitis A outbreak in the US since hepatitis A vaccine became available in1996, and has a mortality rate of ~3.6%.  To prevent and control hepatitis A outbreaks, the California Department of Public Health (CDPH), the Alameda County Public Health Department (ACPHD) and Berkeley Public Health Department (BPH) recommend offering Hepatitis A vaccine to persons who are homeless or who might be using illicit injection or non-injection drugs.  Although there have been no reported cases of hepatitis A in Alameda County or the City of Berkeley associated with these outbreaks or among known homeless or illicit drug users, both ACPHD & BPH encourage hepatitis A virus (HAV) vaccination to prevent an outbreak from occurring locally.

Actions Requested of Clinicans:

  1. PROVIDE HAV vaccine to persons who are homeless and/or who use illicit drugs and to persons who have frequent close contact with the homeless or drug-using populations. This includes those who provide personal care, food service, janitorial, maintenance, or sanitation services to these populations. Serologic testing for HAV immunity is not recommended prior to vaccination. Vaccinate with either single antigen HAV vaccine or the combined HAV/HBV (Twinrix) vaccine.
  2. CONTINUE routine HAV vaccination for:
  3. REPORT immediately all suspect and confirmed HAV cases in homeless or illicit drug users to ACPHD Acute Communicable Disease section by calling 510-267-3250, M-F 8:30a-5p, or after hours call: 925-422-7595. For Berkeley residents only, contact the Berkeley Communicable Disease program by calling 510-981-5292.

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