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August 6, 2019
Washington State Department of Health (DOH) has announced the outbreak of Hepatitis A within Washington State. Multiple states across the country have reported outbreaks of Hepatitis A, primarily among persons experiencing homelessness and persons who use illicit drugs. Since the outbreaks were first identified nationally in 2017, 25 states have publicly reported over 22,500 cases and 13,000 hospitalization. Rates of hospitalization are higher than typical for Hepatitis A infections, and severe complications have been reported, including liver transplantation or death; at least 221 deaths have occurred nationwide.
As of 7/31/19, DOH reports a total of fourteen cases of people who are living homeless or who use drugs since April 1, including one confirmed case in Snohomish County and three confirmed cases in King County. Nine confirmed cases live in Spokane County.
Hepatitis A Clinical Presentation and Testing:
People at highest risk for getting hepatitis are:
Confirmed Case Criteria for Hepatitis A:
Transmission and Infection Control:
Hepatitis A can spread easily in communities experiencing homelessness and crowded settings where handwashing facilities are limited and sanitation is poor. Healthcare providers should be vigilant for potential Hepatitis A infections among persons who are at increased risk, including persons living homeless, persons who use illicit drugs (injection and noninjection), alcohol, and men who have sex with men (MSM).
The best way to prevent Hepatitis A infection is through vaccination with the Hepatitis A vaccine. In February 2019, CDC recommended all persons aged ≥1 year experiencing homelessness be immunized against Hepatitis A. Primary care providers, acute care facilities, and emergency departments should offer Hepatitis A vaccine during clinical encounters to persons at increased risk, Including persons experiencing homeless.
https://www.doh.wa.gov/HepatitisA2019 https://www.doh.wa.gov/ForPublicHealthandHealthcareProviders https://www.cdc.gov/hepatitis/hav/