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A message from the Louisiana Department of Health Emergency Operation Center (LDH EOC)

This is a message for the Louisiana Health Alert Network (LA HAN).

The Louisiana Office of Public Health is investigating an increase in hepatitis A virus (HAV) infections in Morehouse Parish. This increase in cases mirrors the hepatitis A outbreaks occurring in other states, which are occurring primarily among people reporting drug use, people experiencing homelessness, men who have sex with men, incarcerated or recently incarcerated individuals, and close contacts of HAV infected cases. While HAV infection is typically self-limited, morbidity and mortality in the current national outbreaks have been higher than usual due to older age and comorbidities, especially chronic liver disease, of people affected.

Hepatitis A infection is a vaccine-preventable illness that is easily spread through close contact, as well as from sharing injection and non-injection drugs. The primary means of HAV transmission in the United States is typically person-to-person through the fecal-oral route (i.e., ingestion of something that has been contaminated with the feces of an infected person). Symptoms include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored bowel movements, joint pain, and jaundice.

We are asking your assistance to help control the spread of HAV statewide in Louisiana. Since many people at risk may be more likely to engage with the healthcare system in an emergency department setting, rather than primary care, we are asking emergency departments in addition to primary care providers across the state to do the following:

1. Consider hepatitis A diagnosis in anyone with clinically compatible symptoms including jaundice.

2. Immediately contact the Louisiana Office of Public Health Infectious Disease Epidemiology Hotline at 1-800-256-2748 if you suspect a patient with Hepatitis A.

3. Screen all patients, and vaccinate the following groups against hepatitis A based on CDC recommendations:
•Individuals who are MSM
•Individuals who report drug use (both injection and non-injection)
•Individuals who are close contacts of identified cases

4. Encourage hepatitis A vaccination for people experiencing homelessness and incarcerated or recently incarcerated individuals.

Hepatitis A vaccine is typically given as a two-dose series spaced at least six months apart; however, for previously unvaccinated persons, a single dose of hepatitis A vaccine is 95% seroprotective, can provide protection for up to 11 years, and has been demonstrated to help curb outbreaks.