Hepatitis A outbreaks frequently occur in drug users and in people reporting homelessness, according to research published in the Sept. 30 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.
Noting that hepatitis A outbreaks have been reported in 37 states since 2016, Monique A. Foster, M.D., from the CDC in Atlanta, and colleagues analyzed interim data from 33 hepatitis A virus outbreak-affected states to characterize demographic, risk factor, and clinical outcome data from 37,553 outbreak-associated hepatitis A cases, reported from Aug. 1, 2016, to Dec. 31, 2020.
The researchers found that 56 and 14 percent of the persons with available risk factor or clinical outcome information reported drug use and homelessness, respectively; 61 percent had been hospitalized and there were 380 outbreak-associated deaths. The epidemiological shifts identified during these outbreaks led to a 2019 Advisory Committee on Immunization Practices recommendation for vaccination of persons experiencing homelessness and reinforcement of existing vaccination recommendations for persons who use drugs. The number of outbreak-affected states was reduced from 37 to 13 in September 2022, indicating substantial progression in prevention and control of outbreaks.
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