Hepatitis A Person-to-Person Outbreaks: Epidemiology, Morbidity Burden, and Factors Associated With Hospitalization—Multiple States, 2016–2019

Details

• Alternative Title:
  J Infect Dis
• Personal Author:
  Hofmeister, Megan G. ; Xing, Jian ; Foster, Monique A. ; Augustine, Ryan J. ; Burkholder, Cole ; Collins, Jim ; McBee, Shannon ; Thomasson, Erica D. ; Thoroughman, Douglas ; Weng, Mark K. ; Spradling, Philip R.
  More +
• Description:
  Background. ; Since 2016, the United States has experienced person-to-person hepatitis A outbreaks unprecedented in the vaccine era. The proportion of cases hospitalized in these outbreaks exceeds historical national surveillance data. ; Methods. ; We described the epidemiology, characterized the reported increased morbidity, and identified factors associated with hospitalization during the outbreaks by reviewing a 10% random sample of outbreak-associated hepatitis A cases in Kentucky, Michigan, and West Virginia—3 heavily affected states. We calculated descriptive statistics and conducted age-adjusted log-binomial regression analyses to identify factors associated with hospitalization. ; Results. ; Participants in the random sample (n = 817) were primarily male (62.5%) with mean age of 39.0 years; 51.8% were hospitalized. Among those with available information, 73.2% reported drug use, 14.0% were experiencing homelessness, 29.7% were currently or recently incarcerated, and 61.6% were epidemiologically linked to a known outbreak-associated case. Residence in Michigan (adjusted risk ratio aRR = 1.8), being a man who has sex with men (aRR = 1.5), noninjection drug use (aRR = 1.3), and homelessness (aRR = 1.3) were significantly (P < .05) associated with hepatitis A-related hospitalization. ; Conclusions. ; Our findings support current Advisory Committee on Immunization Practices recommendations to vaccinate all persons who use drugs, men who have sex with men, and persons experiencing homelessness against hepatitis A.
• Subjects:
  • Adult
  • Aged
  • Cross-Sectional Studies
  • Disease Outbreaks
  • Female
  • Hepatitis A
  • Homosexuality, Male
  • Hospitalization
  • Humans
  • Immunization
  More +
• Keywords:
  • hepatitis A
  • disease outbreaks
  • hospitalization
  • United States
  • vaccine-preventable diseases
• Source:
  J Infect Dis. 223(3):426-434
• Pubmed ID:
  33097935
• Pubmed Central ID:
  PMC10993993
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  223
• Issue:
  3
• Download URL:
  https://stacks.cdc.gov/view/cdc/154081/cdc_154081_DS1.pdf
• File Type:
  [PDF - 161.50 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:9ad9a71e7158ab231f0bbc1799a345f56dbbadb46706710b930cfee0a713a41f