After an incarcerated person tested positive for hepatitis A virus (HAV), a Los Angeles County jail system initiated a rapid response that helped minimize the risk for transmission and prevent an HAV outbreak, according to the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

In May 2023, an incarcerated person tasked with food preparation in the jail tested positive for acute HAV. Within 48 hours of being notified about the infection, the Los Angeles County’s Correctional Health Services identified the more than 2,700 individuals who had been in the jail during the roughly three-week infectious period, who were offered postexposure prophylactic HAV.

HAV is spread from one person to another when fecal matter from someone with HAV gets into another person’s mouth. Even trace amounts of feces that are too hard to see can cause an infection. What’s more, risk for HAV transmission in congregant housing like correctional institutions is high because of the high rate of injection drug use among incarcerated individuals.

“The prompt vaccine rollout likely helped reduce transmission and prevent an outbreak among the LA County Jail population, and the enhanced surveillance, which included the monitoring of emergency hospital transfers made because of suspicion of acute hepatitis A, helped identify possible secondary cases or clusters needing further investigation,” wrote Nazia Qureshi, MPH, of the Los Angeles County Department of Health Services, and coauthors in the report.

The 41-year-old incarcerated man with HAV had a history of homelessness, drug injection use and alcohol use disorder. On May 25, he sought care for vomiting and received antacids. The report said he felt better but returned to an urgent care facility three days later due to a lack of appetite, abdominal pain, nausea and vomiting. He also had jaundice, a condition that causes yellowing of the skin and whites of the eyes because the liver can’t efficiently process red blood cells as they break down.

Correctional Health Services determined the patient’s infectious period and identified 5,830 people who had been housed in the jail during that time and offered HAV vaccination to 2,766 people who were not vaccinated. More than half (1,510) accepted and received vaccination.

 

No additional cases have been reported or identified since October 2023, according to Morbidty and Mortality Weekly Report.

To read more, click #Hepatitis A or Hep’s Health Basics on Hepatitis A. It reads in part:

HAV is spread from one person to another when fecal matter from someone with HAV gets into another person’s mouth. Even trace amounts of feces that are too hard to see can cause an infection. This can happen in a number of ways: 

  • Eating food—particularly food that is raw or not thoroughly cooked (shellfish, for example)—that has been handled or prepared by someone who has hepatitis A;
  • Drinking water or ice that is contaminated with feces;
  • Close personal contact with a person who is infected with the virus;
  • Engaging in oral-anal sex (“rimming”) with someone who has hepatitis A;
  • Using contaminated water for intravenous drug use.

Hepatitis A is an acute form of hepatitis, meaning that it does not cause long-term (chronic) infection. If you have had hepatitis A once, you cannot be infected with the virus again. However, you can still be infected with other hepatitis viruses, such as hepatitis B virus and hepatitis C virus.

The best way to prevent hepatitis A is to be vaccinated with one of two HAV vaccines: Havrix and Vaqta. Both vaccines require two injections, usually administered six months apart. A combination vaccine for HAV and hepatitis B virus (Twinrix) is also available.

The U.S. Centers for Disease Control and Prevention recommends routine hepatitis A vaccination for:

  • All 1-year-old children;
  • Those who may be at risk for hepatitis A-related complications;
  • People who are at risk for infection or who want protection against hep A.

Hepatitis A vaccination is specifically recommended for:

  • Anyone who has come into direct contact with someone who has hepatitis A;
  • Adults and children traveling to or working in countries with high or intermediate prevalence of hepatitis A, such as those in Central or South America, Mexico, Asia, Africa and Eastern Europe;
  • Children and adolescents up to age 18 who live in states or communities where routine vaccination has been implemented because of high disease rates;
  • Men who have sex with men;
  • People using street drugs;
  • Anyone with an occupational risk for hepatitis A;
  • Persons with chronic liver disease, such as fatty liver disease, alcoholic liver disease, and hepatitis B or C;
  • People who are treated with blood clotting factor drugs.

The hepatitis A vaccine is very effective. More than 99% t of people who are vaccinated develop immunity against the virus and will never get hep A even if exposed to it.