CDC Requests PAs’ Assistance Responding to Hepatitis A Outbreaks

Healthcare Clinic Visits Are an Opportunity for Vaccination

August 13, 2019

The Centers for Disease Control and Prevention (CDC) is requesting assistance from PAs in responding to outbreaks of hepatitis A nationwide. The outbreaks are occurring primarily among people who use drugs, people experiencing homelessness, men who have sex with men (MSM), and contacts of people infected with hepatitis A virus. Visits to a healthcare clinic represent an ideal opportunity to provide hepatitis A vaccination to people at highest risk of infection.

Since August 2016, CDC has received reports of more than 23,638 hepatitis A cases, 14,079 hospitalizations, and 233 deaths associated with person-to-person transmission as of August 5, 2019. While hepatitis A infection is typically self-limited, morbidity and mortality in the current outbreaks are elevated compared to what is normally reported.

CDC is requesting your assistance to help control these hepatitis A outbreaks by vaccinating populations at risk:

• People who use drugs (injection or non-injection)
• People experiencing unstable housing or homelessness
• Men who have sex with men (MSM)
• People who are, or were recently, incarcerated
• People with chronic liver disease, including cirrhosis, hepatitis B, or hepatitis C

One dose of single-antigen hepatitis A vaccine has been shown to control outbreaks of hepatitis A and provides up to 95% seroprotection in healthy individuals for up to 11 years.

• Pre-vaccination serologic testing is not required to administer hepatitis A vaccine.
• Vaccinations should not be postponed if vaccination history cannot be obtained or records are unavailable.

CDC is also requesting that PAs do the following:

• Consider hepatitis A as a diagnosis in anyone with jaundice and clinically compatible symptoms. If no alternative diagnoses are likely, serologic testing for acute viral hepatitis (including anti-HAV IgM) and liver function tests should be ordered.
• Do not test people without signs of acute hepatitis for hepatitis A.
• Ensure all people diagnosed with hepatitis A are reported to the health department in a timely manner. Screen patients for key risk factors (e.g., drug use, homelessness, MSM status, and incarceration) and document their presence or absence in the medical record).

More Resources
Hepatitis A Outbreaks in the United States
Current Outbreak
Hepatitis A Vaccination: Information for Health Care Providers