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CDC committee recommends routine hepatitis A vaccination for homeless people

An advisory committee of the US Centers for Disease Control and Prevention ...

Posted: Oct 24, 2018 5:36 PM
Updated: Oct 24, 2018 5:36 PM

An advisory committee of the US Centers for Disease Control and Prevention unanimously voted Wednesday to recommend the use of routine hepatitis A vaccination for all homeless people ages 1 year and older to protect them against infection. The CDC is expected to approve the committee's recommendation.

Hepatitis A is a disease of the liver caused by a virus. Stomach pain, low appetite, nausea, fatigue and jaundice are common symptoms, which usually end within two months of infection. People usually get sick when they touch a door handle or surface that has been contaminated. Eating contaminated food or drinking contaminated water can also cause sickness. The virus can also be spread through sexual contact or from generally poor sanitary conditions or, if they are drug users, via contaminated needles and other paraphernalia.

Centers for Disease Control and Prevention

Communicable disease control

Diseases and disorders

Government organizations - US

Health and medical

Hepatitis

Homelessness

Liver disease

Poverty and homelessness

Public health

Social and economic status

Societal issues

Society

US Department of Health and Human Services

US federal departments and agencies

Vaccination and immunization

Continents and regions

North America

The Americas

United States

Ten states have reported more than 6,500 hepatitis A infections from January 2017 to October 2018 and homeless people made up more than 40% of the cases occurring in San Diego and Utah, according to the CDC. In Michigan, Kentucky, West Virginia and Tennessee, more than 10% were among homeless people. Not all states include complete information about those who are infected, the agency noted.

The more than 6,000 infections reported by the CDC led to more than 3,800 hospitalizations and an estimated 70 deaths. Sick once, you are protected for life against reinfection. Hepatitis A is also vaccine-preventable. The vaccine comes in the form of a shot, usually given in two doses.

The hepatitis A vaccine first became available in the United States in 1995 and currently there are three licensed vaccines, according to the CDC. Following that year, rates of infection declined by more than 95%. After a long downward trend, the first increase between 2012 and 2013 (1,562 and 1,781 reported cases, respectively), was due to a large multi-state outbreak. Between 2015 and 2016, the reported cases increased by 44.4% from 1,390 in 2015 to 2,007 cases in 2016. After adjusting for under-reporting, the estimated number of new infections in 2016 was 4,000 with this increase due to two outbreaks linked to imported foods.

The current hepatitis A vaccine recommendation includes these at-risk groups: travelers, men who have sex with men, users of drugs, people with clotting-factor disorders, those who work with nonhuman primates, people who anticipate a close personal contact with an international adoptee from a hepatitis A endemic country, and people with chronic liver disease. The CDC also recommended the vaccine for healthy people between the ages of 12 months and 40 years after exposure to the disease. With the new recommendation, homeless people will be included on this list.

Dr. Mona Doshani, a scientist in the division of viral hepatitis within the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the CDC, noted in her presentation to the advisory committee that analysis of data from the US Vaccine Adverse Event Reporting System for a single year ending in 1996 showed more than 400 cases of side effects and 93 serious adverse events among 6 million doses of the hepatitis A vaccine.

On a single night, more than 553,000 people are homelessness in the United States, according to government reports. In a given year, about 3 million people or 1% of the population, are homeless. Just under two-thirds stay in emergency shelters or transitional housing programs, while a third live outside. These homelessness numbers are on the rise, according to the CDC.

Homelessness is associated with a two to three times higher odds of infection with hepatitis A and, if infected, a two to four times higher odds of severe outcomes, such as hospitalization or death, according to a not-yet-published study performed in San Diego County, site of the largest recent outbreak.

The vaccine would be dispensed at clinics where homeless people receive health care and in some states would be covered by Medicaid, according to the CDC.

Minnesota Coronavirus Cases

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Reported Deaths: 2287
CountyConfirmedDeaths
Hennepin32050965
Ramsey13185346
Dakota9146133
Anoka7955148
Stearns525534
Washington517267
Scott315634
Olmsted305029
St. Louis258563
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Clay200843
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Lyon9146
Waseca9089
Crow Wing86821
Chisago8312
Benton8265
Beltrami7537
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Steele7162
Todd6922
Itasca67117
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Freeborn6314
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Martin58416
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Polk4894
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Norman930
Mahnomen911
Grant864
Marshall861
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Kittson270
Cook110

Iowa Coronavirus Cases

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Confirmed Cases: 106765

Reported Deaths: 1522
CountyConfirmedDeaths
Polk17906281
Woodbury678786
Johnson562330
Black Hawk517196
Linn5020123
Dubuque463852
Scott402433
Story383217
Dallas328843
Pottawattamie294044
Sioux228211
Buena Vista219512
Marshall192236
Webster166414
Plymouth153324
Wapello147062
Clinton134625
Muscatine132357
Crawford130312
Cerro Gordo122223
Des Moines12099
Warren11436
Carroll10238
Jasper101934
Henry9735
Marion92010
Tama89336
Lee8689
Dickinson6837
Wright6791
Delaware6728
Boone6718
Bremer6117
Washington60611
Mahaska60122
Harrison5628
Jackson5253
Lyon5117
Benton4971
Louisa49015
Clay4814
Hamilton4313
Winneshiek4299
Poweshiek42811
Hardin4215
Winnebago41916
Kossuth4150
Floyd41211
Jones4053
Emmet39314
Buchanan3893
Cedar3795
Iowa3756
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Guthrie36414
Cherokee3622
Sac3603
Clayton3503
Page3450
Shelby3411
Butler3402
Fayette3372
Madison3372
Mills3341
Allamakee3248
Chickasaw3191
Clarke3083
Cass3022
Palo Alto2831
Grundy2794
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Hancock2724
Calhoun2573
Howard2458
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Monroe23711
Mitchell2270
Monona2261
Taylor2202
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Appanoose1983
Jefferson1881
Lucas1796
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Ida1762
Greene1710
Van Buren1562
Davis1544
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