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National hepatitis A outbreak mostly over in West, but continues in East

National hepatitis A outbreak mostly over in West, but continues in East


The national hepatitis A outbreak has not yet burned out. Since 2016, 35 states have reported 38,476 hepatitis A cases. Through April 2, 2021, 61 percent or 23,373 of the stricken have required hospitalization, and 365 have died.
The Division of Viral Hepatitis at the federal Centers for Disease Control and Prevention (CDC) since 2017 has actively assisted state and local health departments with hepatitis A cases. Nine states, mostly in the West, have declared their Hepatitis A outbreaks as over.
Person-to-person transmission of hepatitis A remains a problem in 26 states. Several groups continue to be more likely than others to become infected with hepatitis A. These include:

People who use drugs, injection, and non-injection.
Homeless people or those who are experiencing unstable housing.
Men who have sex with men. (MSM)
People in jail or recently incarcerated.
People with chronic liver disease, including cirrhosis, hepatitis B or C.

Hepatitis A spread by contaminated food and water is possible, but that’s not a principal concern in the current national outbreak.
Hepatitis A is one of the common liver diseases. It inflames the vital organ that processes nutrients, filters the blood, and fights infections. While heavy drinking can damage the liver, a virus usually brings out Hep A.
And CDC recommends the Hep A vaccine as the best way to prevent HAV infection. A one-dose single-antigen hepatitis A. vaccine is proven to control Hepatitis A outbreaks.
States — all east of the Mississippi River — with the most hepatitis A cases include Kentucky (5,132), Florida (5,024), Ohio (3,720), and Tennessee (3036).
State and local health departments haven’t yet extinguished the outbreak in 26 Eastern states, including the big four. Two eastern states, West Virginia and Massachusetts have declared their Hep A outbreaks as over.
Arizona, California, Colorado, Idaho, Nevada, New Mexico, and Utah have declared an end to their outbreaks. In the West, only Kansas and Washington State continue to experience cases.
 

State-Reported Hepatitis A Outbreak Cases as of April 2, 2021











State-Reported Hepatitis A Outbreak Cases and Clinical Outcomes
 



State
Case Total
Hospitalizations n (%)
Deaths
Outbreak Start Date
Data Current Through




Total (35 states)
38476
23373 (61%)
365




States with an ongoing outbreak (n=26)







Alabama
1177
812 (69%)
NR
9/1/2018
12/31/2020


Arkansas
482
256 (53%)
3
2/7/2018
3/6/2020


Delaware
38
28 (74%)
1
8/1/2019
1/22/2021


Florida
5024
3417 (68%)
76
1/1/2018
2/28/2021


Georgia
1622
1038 (64%)
8
6/1/2018
3/27/2021


Illinois
211
141 (67%)
1
9/1/2018
10/1/2020


Indiana
2471
1376 (56%)
4
11/1/2017
11/25/2020


Kansas
343
285 (83%)
3
5/15/2020
2/12/2021


Kentucky
5132
2449 (48%)
64
8/1/2017
2/25/2021


Louisiana
1533
904 (59%)
7
1/1/2018
3/18/2021


Maryland
370
264 (71%)
4
12/1/2019
4/1/2021


Michigan
920
738 (80%)
30
8/1/2016
2/5/2020


Minnesota
128
89 (70%)
1
12/16/2018
3/26/2021


Mississippi
187
129 (69%)
0
4/1/2019
2/26/2020


Missouri
697
403 (58%)
2
9/1/2017
3/14/2020


New Hampshire
319
198 (62%)
2
11/1/2018
2/11/2020


New Jersey
777
397 (51%)
11
12/1/2018
3/2/2021


New York (excluding New York City)
482
322 (67%)
0
6/1/2019
3/27/2021


North Carolina
482
300 (62%)
5
1/1/2018
1/23/2021


Ohio
3720
2317 (62%)
16
1/1/2018
3/29/2021


Pennsylvania
886
678 (77%)
15
1/1/2018
3/27/2021


South Carolina
1911
992 (52%)
8
11/1/2018
1/22/2021


Tennessee
3036
1839 (61%)
28
12/1/2017
5/8/2020


Vermont
34
19 (56%)
0
1/1/2019
2/27/2021


Virginia
476
295 (62%)
2
1/1/2019
3/25/2021


Washington
366
212 (58%)
5
4/1/2019
6/22/2020


States with a declared end to their outbreak (n=9)







Arizona
598
484 (81%)
8
11/1/2018
4/16/2020


California
708
464 (66%)
21
11/1/2016
4/11/2018


Colorado
418
296 (71%)
2
10/1/2018
2/1/2021


Idaho
77
39 (51%)
0
1/1/2019
11/1/2020


Massachusetts
563
442 (79%)
9
4/1/2018
5/29/2020


Nevada
107
94 (88%)
1
11/1/2018
6/18/2020


New Mexico
168
127 (76%)
2
11/8/2018
6/10/2020


Utah
281
152 (54%)
3
5/8/2017
2/12/2019


West Virginia
2732
1377 (50%)
23
3/19/2018
8/24/2020

















NR: not publicly reported

“Outbreak-associated” status is currently determined at the state level in accordance with each state’s respective outbreak case definition.
Outbreak-related hepatitis A deaths are defined at the state level in accordance with each state’s respective hepatitis A-related death definition. Some states are reviewing death certificates on a regular basis to actively find hepatitis A-related deaths, while other states are utilizing passive surveillance.
Outbreak start date is defined at the state level and may represent the earliest onset date of an outbreak case (AR, AZ, KS, UT), the left censor date for which cases are considered part of the outbreak based on the state outbreak case definition (AL, CA, CO, DE, FL, GA, ID, IL, IN, KY, LA, MD, MA, MI, MN, MO, MS, NV, NH, NJ, NC, OH, PA, SC, TN, VA, WA), or when a state declared a hepatitis A outbreak (NM, WV).


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