MMWR Morb Mortal Wkly Rep. 2023 Apr 7;72(14):362-365. doi: 10.15585/mmwr.mm7214a2.
Hepatitis A is a vaccine-preventable liver infection caused by the hepatitis A virus (HAV); it is transmitted through ingestion of food or drink that has been contaminated by small amounts of infected stool, or through direct contact, including sexual contact, with a person who is infected (1). After years of historically low rates of hepatitis A in the United States, the incidence began increasing in 2016, with outbreaks characterized by person-to-person HAV transmission among persons who use drugs, persons experiencing homelessness, and men who have sex with men (2,3). As of September 2022, 13 states were experiencing outbreaks, including Virginia (3). In September 2021, the Roanoke City and Alleghany Health Districts (RCAHD) in southwestern Virginia investigated an outbreak of hepatitis A. The outbreak, which resulted in 51 cases, 31 hospitalizations, and three deaths, was associated with a food handler who was infected. After the outbreak, the community experienced ongoing person-to-person transmission of HAV, predominantly among persons who use injection drugs. As of September 30, 2022,* an additional 98 cases had been reported to RCAHD. The initial outbreak and community transmission have exceeded US$3 million in estimated direct costs (4,5). This report describes the initial outbreak and the ongoing community transmission of HAV. Increasing vaccination coverage among persons with risk factors for hepatitis A infection is important, including among those who use drugs. Strengthening community partnerships between public health officials and organizations that employ persons with risk factors for acquisition of HAV could help to prevent infections and outbreaks.
甲型肝炎是一种由甲型肝炎病毒（HAV）引起的可通过疫苗预防的肝脏感染；它通过摄入被少量受感染粪便污染的食物或饮料，或通过与感染者（1）直接接触（包括性接触）传播。在美国，甲型肝炎的发病率多年来一直处于历史低位，但自 2016 年以来，发病率开始上升，疫情的特点是在使用毒品、无家可归者和男男性接触者等人群中发生人与人之间的 HAV 传播（2,3）。截至 2022 年 9 月，有 13 个州正在经历疫情爆发，包括弗吉尼亚州（3）。2021 年 9 月，弗吉尼亚州西南部的罗阿诺克市和阿勒格尼卫生区（RCAHD）调查了一起甲型肝炎疫情。该疫情导致 51 例病例、31 例住院和 3 例死亡，与一名受感染的食品处理人员有关。疫情爆发后，该社区继续发生人与人之间的 HAV 传播，主要发生在使用注射毒品的人群中。截至 2022 年 9 月 30 日*，RCAHD 又报告了 98 例病例。最初的疫情和社区传播已经造成了超过 300 万美元的直接估计成本（4,5）。本报告描述了最初的疫情和正在进行的社区 HAV 传播。增加甲型肝炎感染风险因素人群（包括使用毒品者）的疫苗接种覆盖率很重要。加强公共卫生官员与雇用有 HAV 感染风险因素的人员的组织之间的社区伙伴关系，有助于预防感染和疫情爆发。
