Hepatitis A Virus: Wreaking Havoc for Public Health

Author: Holly Montejano, MS, CIC, CPHQ, VA-BC

Hepatitis A virus (HAV) is not for the faint of heart! This highly contagious and vaccine-preventable virus attacks the liver, with symptoms including fever, jaundice (yellowing of the skin and eyes), stomach pain, lack of appetite, and nausea, and for otherwise healthy individuals, reaching the road to recovery could take several weeks ¹.

Young children often have no symptoms of the illness. However, for those with underlying liver issues, this illness can lead to liver failure and even death ¹.  Hepatitis A virus is often spread person-to-person via the fecal-oral route or from consuming contaminated food or water ¹. This virus is resilient and very difficult to kill, allowing it to live on surfaces for months outside the human body.

The National Impact of Hepatitis A:

Hepatitis A remains a challenge for public health across the nation. Centers for Disease Control and Prevention (CDC) reports that Hepatitis A incidence has increased by 1,325% from 2015-2019 ². This increase was due to an unprecedented number of person-to-person outbreaks in 31 states. Among the reported cases with injection drug use (IDU) information available, 46% of cases reported the behavior; individuals experiencing homelessness are also at elevated risk for Hepatitis A ².

A 2019 Morbidity and Mortality Report (MMWR) also reports an increase in reported infections in men who have sex with men (MSM), and to a lesser extent, cases associated with consumption of HAV-contaminated food ³.

The importance of those who are eligible to receive the HAV vaccine, as well as appropriate handwashing and surface cleaning in both food handling and healthcare environments cannot be underestimated from a public health and infection prevention perspective!

Climate Change and Hepatitis A:

In 2019 The Lancet reviewed the impact of climate change on Hepatitis A, particularly in countries where the virus is considered endemic ⁴.  Climate change impacts global health in the form of natural disasters involving flooding- and the transmissibility of waterborne infections, one of which is HAV ⁴.  The impacts of climate change are felt around the globe, and certainly here in the United States with the threat of heavy rains causing flooding which can potentiate compromised sewer systems; HAV infections can become problematic from an environmental standpoint causing clusters of infections post-flood.

Hepatitis A Virus Prevention:

While there is a vaccine for Hepatitis A, most people in the US only receive this if they are traveling abroad to an area with endemic infection or if they have been exposed to a known contact ¹. If you think you may have been exposed to someone infected with this virus you should contact your physician or your local health department to receive the hepatitis A vaccine, and if it is decided that you are a high-risk, close contact you may also be given an injection of immune globulin.