Hepatits A Outbreak Response

About the Program

Category: Risk and Emergency Management (Best in Category)

Year: 2020

The number Hepatitis A cases began declining dramatically in the United States after the Hepatitis A vaccine was recommended in 1996. By 2015 there were 1,390 cases reported nationwide. In late 2016, outbreaks began appearing sporadically across the nation. These outbreaks evolved into a nationwide outbreak with more than 31,000 cases with high hospitalization, severe complication, and fatality rates. In January 2019, Maricopa County detected an increase in Hepatitis A cases. Investigation of these cases identified three common risk factors: drug use, homelessness or unstable housing, and recent incarceration. These factors were consistent with risk factors associated with the national Hepatitis A outbreak.Throughout 2019, Maricopa County guided by the Advisory Committee on Immunization Practices recommendations and by researching the outbreak response activities of several jurisdictions, developed a targeted immunization program focused on the high-risk categories. The most effective approach was providing Hepatitis A vaccine to inmates during the intake process at Maricopa County jails 24-hours a day 7 days a week. This activity had the largest impact in decreasing the case rate by approximately 89% (See Appendix C) within 4 months at a cost of $2.5 million which is substantially less than outbreaks of similar magnitude in other jurisdictions.