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JAMA Insights
July 6, 2020

Management of Hepatitis A in 2020-2021

Author Affiliations
  • 1Fishbein Fellow, JAMA, Chicago, Illinois
  • 2Division of Infectious Diseases, Massachusetts General Hospital, Boston
  • 3Harvard Medical School, Boston, Massachusetts
JAMA. 2020;324(4):383-384. doi:10.1001/jama.2020.4017

Hepatitis A virus (HAV) is a common cause of viral hepatitis.1 Following decades of improved sanitation and hygiene measures and the introduction of HAV vaccination in 1995, the number of infections in the US declined by nearly 95% between 1996 and 2011, from 31 032 to 1398 reported cases yearly. However, HAV infections increased between 2016 and 2018 with an estimated 15 000 reported cases over this period, largely associated with outbreaks related to drug use and homelessness.1 Other recent infections in the US have occurred among men who have sex with men and during large foodborne outbreaks.1 These outbreaks have signaled an epidemiological shift in the US from small events typically associated with consumption of contaminated food, childcare centers, or unvaccinated travelers returning from endemic settings, to large outbreaks in networks characterized by person-to-person transmission.1,2

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