NH in Early Stages of Hepatitis A Outbreak

NH DPHS Health AlertOn February 5, 2019, NH DHHS issued a health alert regarding a Hepatitis A outbreak in the state.

Key Points and Recommendations:

  1. There have been 13 new cases of acute hepatitis A infections reported in the last three months in New Hampshire (NH). This is marked increase over the annual average of 6-7 cases (range: 1-10 cases from 2013-2017). Most of these individuals have reported either experiencing homelessness or recreational drug use (injection and non-injection), and have resided across the southern part of our State in the counties of Hillsborough (5), Rockingham (3), Strafford (3), Cheshire (1), and Merrimack (1)
  2. There are large outbreaks of hepatitis A occurring across the country in at least 16 different states.
  3. These outbreaks have often started in individuals experiencing homelessness and those with substance use disorder, and then transmission has spread to the general population. More than 70% of individuals have required hospitalization.
  4. Clinicians should consider hepatitis A infection in anybody presenting with jaundice and/or a clinically compatible illness. For more information, review the prior HAN sent June 2018.
  5. Hepatitis A is preventable with administration of the hepatitis A vaccine. More than 95% of individuals will develop protective antibodies after a single dose of the monovalent hepatitis A vaccine; nearly 100% will develop protective antibodies after a 2-dose series. Protection lasts at least 10-years and probably longer. The hepatitis A vaccine also comes in a formulation combined with hepatitis B vaccine called Twinrix®, which is licensed for individuals >18 years of age and requires a 3-dose series; about 94% of individuals will develop protective antibodies to hepatitis A after a single dose of Twinrix® (but only 31% will develop antibodies against hepatitis B after a single dose): https://www.cdc.gov/hepatitis/outbreaks/InterimOutbreakGuidance-HAV-VaccineAdmin.htm

Read the full alert for details on prevention and vaccination.

Read the Full DHHS Alert