On August 1, 2019, the Department of Public Health declared a public health emergency to address the rise in hepatitis A in Philadelphia.

  • What is hepatitis A?
    • Hepatitis A is a contagious liver disease caused by the hepatitis A virus.
  • What are the symptoms of hepatitis A?
    • Some people infected with the virus do not have any symptoms. The symptoms of hepatitis A can include:
      • Fever
      • Dark urine
      • Fatigue (tiredness)
      • Clay colored or pale stools
      • Nausea and vomiting
      • Joint pain
      • Abdominal pain
      • Jaundice (yellowing of the eyes and skin)
    • Symptoms usually appear anywhere from two to six weeks after exposure to the virus, and usually last less than two months. Some people can be sick for as long as six months.
  • How does hepatitis A spread?
    • Hepatitis A is usually spread when the virus enters the body through the mouth from contact with objects, food, or drinks that have been contaminated by the feces (poop) of an infected person. It can spread through improper handwashing after a bowel movement, changing diapers or cleaning up the stool of an infected person, or through sexual activities such as oral-anal contact with a person infected with the hepatitis A virus. Hepatitis A can also be spread by eating food or drinking water contaminated with the virus, including frozen and undercooked food. People who have hepatitis A infection can spread it to others two weeks before and one week after developing symptoms.
  • Who is at risk from catching hepatitis A?
    • People who come in contact with feces from an infected person and then do not wash their hands properly can become infected if they touch their mouths or food that they consume.  Hepatitis A can also be spread through sexual contact, particularly through oral-anal practices, which increases risk of transmission for men who have sex with men.  Traveling internationally to countries where sanitation is poor and where the hepatitis A virus is more prevalent in the environment increases risk of exposure.  People who have had two doses of hepatitis A vaccine or who have had previous infection with hepatitis A are considered immune and protected from future exposures.
  • How many cases of hepatitis A have occurred in this outbreak?
    • In 2019, the Philadelphia Department of Public Health has confirmed 154 cases of acute hepatitis A infection as of August 1 and is investigating several additional reports.  Since introduction of the hepatitis A vaccine as a routine immunization for children, the city typically receives anywhere from two to nine reports each year.
  • Who is getting sick in this current outbreak?
    • All but four of the confirmed cases have occurred in adults older than 18 years. Many cases have reported using drugs (currently or in the past) or are experiencing homelessness.  Other reports have occurred among men who have sex with men and among people who have traveled internationally where hepatitis A is more prevalent in the environment.  A small percentage of cases in this outbreak have not reported any high-risk activity.
  • What should I do if I am exposed?
    • Hepatitis A vaccine can be given to help prevent infection in healthy persons who are 12 months of age and older and have been exposed to someone who was ill with hepatitis A. The vaccine should be given as soon as possible and within two weeks to ensure it is most effective.
    • Persons who have previously received two doses of hepatitis A vaccine OR have a history of hepatitis A infection are considered protected and will not need to be vaccinated following an exposure.
    • Persons who have an underlying condition that suppresses the immune system should contact their primary healthcare provider or the Health Department at 215-685-6742, since an antibody product is recommended for you along with the hepatitis A vaccine.  This product should be given within two weeks of the exposure.
    • To ensure you are protected from hepatitis A exposures in the future, persons who receive hepatitis A vaccine following a specific exposure should get a second dose of the hepatitis A vaccine six months later.
  • What should I do if I think I have hepatitis A?
    • If you think you have hepatitis A, you should contact your doctor.
  • How is hepatitis A prevented?
    • The best way to prevent hepatitis A is through vaccination with the hepatitis A vaccine. Frequent hand washing with soap and warm water after using the bathroom, changing a diaper, or before preparing food can help prevent the spread of hepatitis A.
  • What is the Health Department doing to control this outbreak?
    • Since the summer of 2018, the Health Department has conducted extensive outreach to raise awareness and provide hepatitis A vaccine and personal hygiene items to high-risk populations and potentially exposed persons living in neighborhoods with increased disease burden.  The Health Department has also been working with Prevention Point Philadelphia, homeless shelters, hospital emergency departments, the Philadelphia Department of Prisons, and other City agencies who serve at-risk populations to expand outreach, promote vaccination, and increase the Department’s access to these high-risk groups, and has conducted street outreach to interact with these populations to directly offer hepatitis A vaccine. The Health Department has also issued six health alerts since Fall of 2017 to the healthcare community raising awareness about national and local increases and providing instructions on how to recognize and prevent infection.
  • Where can I get more information?
    • For information about your vaccine history or interest in receiving vaccine, contact your doctor or primary care provider.
    • Go to the Centers for Disease Control and Prevention (CDC) website for more detailed information about hepatitis A transmission, risks, prevention and outbreaks affecting other parts of the country at https://www.cdc.gov/hepatitis/hav/
    • For local updates and guidance for clinical providers, visit the Philadelphia Health Information Portal at http://www.phila.gov/Health/.
    • Contact the Philadelphia Department of Public Health, Division of Disease Control, at  (215) 685-6740 for information about the outbreak and how you can protect yourself.