Florida Declares Public Health Emergency in Response to Hepatitis A Outbreak

Florida Surgeon General Scott Rivkees, MD, has declared a public health emergency in Florida in response to the statewide hepatitis A outbreak.

The Sunshine State has documented 2582 hepatitis A cases between January 1, 2018, and July 27, 2019. According to the Florida Department of Health, 98% of cases in this outbreak have been acquired within the state. Additionally, case counts in 2019 have already surpassed the total number of cases recorded in 2018.

"I am declaring this public health emergency as a proactive step to appropriately alert the public to this serious illness and prevent further spread of hepatitis A in our state," Rivkees said in a press release. "The best way to prevent hepatitis A is through vaccination. It is important that we vaccinate as many high-risk individuals as possible in order to achieve herd immunity.”

Prior to declaring a public health emergency, State Surgeon General Celeste Philip, MD, MPH, issued a public health advisory in November 2018, which reemphasized the importance of hepatitis A vaccine recommendations following a “substantial increase” in infections across the state.

Under the new declaration, the state health agency will request assistance from the US Centers for Disease Control and Prevention (CDC) in controlling and responding to the outbreak. It is also important for Florida health care providers to understand the importance of screening and vaccinating individuals at high-risk for acquiring hepatitis A. Although anyone can contract the virus, high-risk populations include individuals experiencing homelessness, intravenous and non-intravenous drug users, and men who have sex with men.

The declaration also recommends vaccination for individuals who may have an increased risk of suffering from complications associated with hepatitis A, including those with chronic liver disease, clotting factor disorders, and adults over the age of 60 years with underlying medical conditions who reside in a county with a high level of transmission occurring.

As of July 26, 2019, hepatitis A outbreaks have been identified in 25 states since 2016. A total of 22,566 cases, 13,352 hospitalizations, and 221 deaths have been reported.

The ongoing hepatitis A outbreaks in the United States were first identified in 2016 and, since March 2017, the CDC has been working alongside state and local health departments to respond to the outbreaks.

The 3 states with the largest ongoing outbreaks include Kentucky (4793 cases), Ohio (3234), and West Virginia (2533). The CDC’s Division of Viral Hepatitis emphasizes that the hepatitis A vaccine is the best way to prevent hepatitis A infection.

Earlier this year the Advisory Committee on Immunization Practices (ACIP) voted to update recommendations on the use of vaccines to protect against hepatitis A.

The committee voted unanimously to recommend that all children and adolescents between the ages of 2 and 18 years who have not previously received the hepatitis A vaccine should receive a catch-up vaccination. ACIP also voted unanimously to recommend updating the language around using the hepatitis A vaccine in the Vaccines for Children program.

Both recommendations are currently under review by Robert Redfield, MD, director of the CDC, along with the US Department of Health and Human Services.

For the most recent case counts in the hepatitis A outbreaks, check out the Contagion® Outbreak Monitor.