February 13, 2020

Maine CDC Encourages Providers to Obtain Vaccine and Vaccinate At-Risk Populations for Hepatitis A

In 2019, Maine saw a nearly five-fold increase in hepatitis A cases over the five-year average number of cases, increasing from 9 in 2018 to 45 in 2019. A quarter of the cases in 2019 had risk factors such as injection drug use or homelessness.

Maine CDC recommends that healthcare providers and facilities that provide services to at-risk populations obtain hepatitis A vaccine and offer vaccination to their clients to prevent further spread of hepatitis A.

• Screen patients for risk factors (e.g., drug use, homelessness, incarceration, MSM, and chronic liver disease).
• Recommend and administer hepatitis A vaccine to at-risk patients, regardless of the original presenting complaint or the type of clinical facility. In particular, the emergency department may be an individual's only interaction with the healthcare system and is an important opportunity for prevention.
• Record immunizations in the state immunization information system (registry).
• Consider hepatitis A as a diagnosis in anyone with jaundice, elevated liver enzymes, or clinically compatible symptoms. Order an acute hepatitis panel to include hepatitis A IgM on these patients.

Rapidly report all persons diagnosed with hepatitis A to the health department to ensure timely case investigation and follow-up of contacts.

Advisory (PDF)