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Update on Hepatitis A Outbreak in LA County

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Los Angeles County Public Health recently released a health report including an update about the current Hepatitis A outbreak in LA County.

The key points of report were:

  • An increased number of cases of hepatitis A virus (HAV) is occurring among men who have sex with men (MSM) in Los Angeles County in 2017 compared with 2016.
  • This increase is occurring in the context of an outbreak of hepatitis A in LA County among persons who are homeless or use illicit (injection and non-injection) drugs.
  • All MSM should be offered HAV vaccination.  Vaccination is the best method for preventing HAV infection.
  • The combined HAV/hepatitis B (HBV) vaccine (Twinrix), should be used for MSM as supplies of the single antigen HAV vaccines (Havrix and Vaqta) are constrained.

Providers are encouraged to:

  • Attend the live LAC DPH webinar on HAV with Q&A occurring on Wednesday, November 8 at 12 pm. Free CME is available. Register here to participate. The webinar will be recorded for those who cannot make it.
  • Vaccinate individuals at increased risk for HAV or its consequences
    • Including MSM, persons who are homeless and/or who use illicit drugs, and those with chronic liver disease or HIV infection.
  • Consider pre-screening for hepatitis A immunity in patients who can be expected to follow-up for vaccination.
    • Due to current vaccine constraints, providers may consider offering testing for anti-hepatitis A virus IgG to patients lacking documentation of vaccination as they may already be immune. If there are any concerns about follow-up, the patient should be vaccinated without delaying for antibody testing.
  • Vaccinate MSM patients against other pathogens currently causing outbreaks in LA County. 
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