Single-antigen HAV vaccine and immune globulin (IG) are effective HAV PEP therapies.

Provide post-exposure prophylaxis (PEP) for close contacts of confirmed hepatitis A cases as directed by LAC DPH. Susceptible people exposed to HAV should receive PEP as soon as possible within 2 weeks of last exposure.

For assistance, call: 88 during business hours and 21 after hours.

Health Officer orders are available to facilitate holding patients for discharge planning. Do not discharge patients with hepatitis A to the street or communal shelter until at least 7 days after the onset of jaundice (14 days after the onset of symptoms if no jaundice). LAC DPH may be able to assist with finding placement for infectious but medically stable patients who are ready for discharge.Report acute hepatitis A infection in other patients within 1 working day from identification. Providers must report while suspected cases are still at the health care facility to facilitate immediate interview by a public health investigator and prophylaxis of contacts.

Immediately report all suspect and confirmed hepatitis A cases in persons experiencing homelessness or using illicit drugs to the LAC DPH Morbidity Unit by calling 88 (after hours call 21).Do not test asymptomatic people for HAV infection as the false positive rate is high. HIV testing is also recommended for those with an undocumented HIV-status. Please hold an additional serology specimen, which LAC DPH will collect. A complete serology panel with testing for hepatitis A (for acute HAV order IgM), B, and C is recommended in symptomatic patients. Consider hepatitis in patients with abrupt onset of prodromal symptoms (nausea, anorexia, fever, malaise, or abdominal pain) and jaundice or elevated serum aminotransferase levels. Suspect hepatitis A infection in any patient presenting with jaundice or hepatitis symptoms who reports experiencing homelessness or using illicit drugs within the last 2 months. This also applies to persons with close contact with these groups.Proactive vaccination in these high-risk populations will help prevent further disease transmission. It is important that clinicians remain vigilant for additional hepatitis A cases due to the long period between exposure and onset of illness. These are the first reported cases of hepatitis A in Los Angeles County among persons experiencing homelessness since February of this year. The fatality rate of hepatitis A in this population is higher than the rate observed in healthy individuals. The cases are known to each other, although the original source of infection has not been identified. Since mid-October, LAC DPH has identified 3 cases of hepatitis A in individuals currently experiencing homelessness and/or who use illicit drugs. Patients suspected or confirmed to have hepatitis A should not be discharged to the street or to congregate settings while still infectious.This will facilitate an on-site interview by a public health investigator and prophylaxis of contacts. Immediately report suspect cases of hepatitis A infection by phone-while the patient is still at the clinical facility- if the patient is experiencing homelessness and/or uses illicit drugs.Promote hepatitis A vaccine to persons experiencing homelessness and/or who use illicit drugs and to persons with frequent close contact with these at-risk populations.The Los Angeles County Department of Public Health (LAC DPH) has identified three new cases of hepatitis A virus (HAV) among persons who are experiencing homelessness and/or who use illicit (injection and non-injection) drugs.This message is intended for infectious disease, primary care, emergency medicine, urgent care, emergency medical services, and health care personnel who provide services to persons experiencing homelessness and/or who use illicit drugs. Women Physicians Issues and Advocacy Committee.Asian American Pacific Islander Physicians Advisory Committee.African American Physicians Advisory Committee.150th Anniversary Member Appreciation Event.

Hepatitis a transmission los angeles ca