Most Hepatitis A Outbreaks Are Unannounced in the USA

HepA infected food service staff related to 275 outbreaks
waiter serving a salad

The USA has been experiencing person-to-person outbreaks of hepatitis A in unprecedented numbers during the vaccine era. 

As of May 2020, 33 states had reported hepatitis A (HepA) outbreaks involving approximately 32,500 cases reported by the Centers for Disease Control and Prevention (CDC).

Moreover, there have been 19,800 (61%) hospitalizations and 320 related fatalities since this HepA outbreak began in Michigan during 2016. 

Hepatitis A is a liver infection caused by a virus that is spread primarily through close contact among persons who use drugs and persons experiencing homelessness, as well as among men who have sex with men.

During these outbreaks, hepatitis A infections occurring among food handlers have raised public alarm and resulted in calls for vaccinating all food handlers, often prompting health departments to divert limited resources away from populations at risk. 

However, the risk for secondary transmission from hepatitis A–infected food handlers to food establishment patrons has been not well understood. 

To characterize this risk, a novel structured survey was developed and conducted using Research Electronic Data Capture among 29 state health departments reporting person-to-person hepatitis A outbreaks from July 2016–September 13, 2019.

Among these hepatitis A outbreak cases, only 871 (3.8%) were among food handlers.

And, among 275 cases in food handlers from these states, just 63 (22.9%) public notifications took place.

These findings indicate that the risk for secondary infection from hepatitis A–infected food handlers to food establishment patrons in these outbreaks is low (<1.0%). 

Therefore, public health efforts to preemptively vaccinate all food handlers would be ineffective at mitigating the current risk for person-to-person outbreaks. 

Furthermore, to optimize resources, health departments should assess the risk for secondary transmission of hepatitis A from infected food handlers on a case-by-case basis and prioritize vaccination efforts in situations where secondary transmission risk is deemed high, stated these researchers.

As of June 2020, the CDC says just 1-dose of a single-antigen hepatitis A vaccine provides up to 95 percent seroprotection in healthy individuals for up to 11 years.

There are 3 HAV vaccines approved in the USA: Vaqta, Havrix, and Twinrix, which are available at most pharmacies in the USA.

Hepatitis A vaccination news is published by Precision Vaccinations.