Hepatitis A cases in the US have swelled by nearly 300 percent in three years, new Centers for Disease Control and Prevention (CDC) figures reveal.
Between 2016 and 2018, 91 percent of the specimens the CDC tested for hepatitis A, compared to 87 percent of specimens from the 2013 to 2015 period.
In total, about 15,000 cases of hepatitis A were reported to the CDC in the most recent period.
Although hepatitis A transmission is often associated with men who have sex with men, in recent years the opioid epidemic has fueled needle sharing and increasing homelessness, which health officials say have led to the virus’s spread.
Throughout the US, hepatitis A cases have increased by nearly 300 percent, with increases of 500 percent or more in nine states and Washington, DC (dark blue) the CDC reports
Between 2013 and 2018, hepatitis A cases increased or remained stable in 18 states.
In nine states – Hawaii, West Virginia, Mississippi, Missouri, Arkansas, Indiana, Ohio, Kentucky and Tennessee – plus Washington DC, increases of about 500 percent were reported.
The increases are particularly staggering because hepatitis A is an entirely preventable disease.
Children in the US are supposed to be vaccinated against the virus between ages one and two, in two doses.
But it isn’t entirely clear how long the vaccine’s protection lasts, though the CDC says that it should provide immunity for at least 10 years.
In the nearly two-and-a-half decades since the hepatitis A vaccine was introduced in the US, overall incidence of infections has fallen.
Yet intermittent up-surges have become more frequent and significant in recent years.
‘A large population of susceptible, unvaccinated adults who were not infected by being exposed to the virus during childhood remain vulnerable to infection by contaminated foods (typically imported from countries with endemic HAV transmission),’ the CDC report says.
‘And recently, on a much larger scale, through behaviors that increase risk for infection in certain vulnerable populations, such as drug use.’
Hepatitis is a viral liver infection that can cause nausea, vomiting, fatigue and abdominal pain.
Unlike hepatitis B and C, it does not typically lead to chronic infection and liver disease, though it has proven deadly when left untreated, in rare cases.
The disease typically spreads when people ingest infected fecal matter.
This transmission route puts homeless populations and those living in unsanitary conditions particularly susceptible.
And health experts in areas with particularly bad outbreaks suspect that the disease gets carried into restaurants and the food they serve by homeless populations.
Hepatitis A may end up in these restaurants as a result of injection drug use as well.
Although it most commonly spread through the fecal-oral route, the virus is, of course, also carried in the bloodstream.
So when users of injection drugs like heroin share needles or use unclean needles, the disease can easily spread, suggesting to most health officials that the opioid epidemic underlies the increasing rates of hepatitis A as well.
