Hepatitis A on the Rise — Here's Why and What to Do

Hepatitis A popped up the CDC’s radar in 2017 when the agency first became aware of widespread outbreaks. Since 2016, over 17,000 cases have been reported, including 170 deaths. We have details on the underlying epidemics that led to it all.

Cases of hepatitis A dropped dramatically after vaccine recommendations in 1996, but reports of the disease skyrocketed again in 2016. Hep A is most prevalent in IV drug users, but it can also be transmitted sexually and through contact with contaminated food. Officials believe two major factors in the increase are the opioid epidemic and homelessness. Opioid users may engage in IV drug use and risky sex, while the homeless population can be subjected to unsanitary conditions, drug use and secondhand food. 

What is Hepatitis A?

Hepatitis A is a viral infection that affects the liver and can cause fatigue, nausea, stomach pain, appetite loss and jaundice. Most cases resolve on their own within a couple of months, although the disease may persist in some people for up to six months. People with chronic liver diseases are at a much higher risk of suffering acute liver failure, which can be deadly.

Because hepatitis A spreads mainly through contact with infected blood and fecal matter, the disease is most prevalent among intravenous (IV) drug users. A dirty environment can increase risks, as can eating food touched or prepared by an infected person with poor hygiene. Hepatitis A can also spread through unprotected sex and is more common among homosexual men. The infection is also seen more among those who have been recently incarcerated.

Epidemics Fueling an Epidemic

The Advisory Committee on Immunization Practices (ACIP) started recommending hepatitis A immunizations in 1996, and infection rates declined steadily for many years. Then, in 2016, the numbers suddenly skyrocketed once more. Officials believe the opioid epidemic may be responsible for the bulk of the sudden jump. This is mainly because the virus spreads so easily through infected needles. Non-IV drug users also have a higher exposure rate because they’re more likely to engage in unprotected sex and other high-risk behaviors.

The epidemic of homelessness is another big contributor since people living on the streets are often subjected to secondhand food and unsanitary living conditions. Homeless people are more likely to use drugs, and the combination often goes hand-in-hand with prostitution, which can also increase the risk of disease. The CDC recommends pushing vaccinations in all high-risk groups to stop the hepatitis epidemic in its tracks.

More vaccinations might reduce the spread of disease, but the underlying issues still need to be addressed. Until we get a handle on the opioid epidemic the fallout will continue. And until we find more effective ways to end homelessness, people are going to continue having their challenges compounded by this disease just when things are at the worst.

Hepatitis A might be on the rise, but you don’t have to fall victim to it. Be safe about where you go and the activities you engage in. If you abuse drugs, seek recovery. Consider getting vaccinated if you interact with people who could expose you or if you are subjected to unsanitary conditions, as the vaccine is 94% effective in preventing the disease.