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APHA Scientific Session and Event Listing

Recorded presentation

Rachel Plotinsky, MD¹, Jane Manning, MPH², Elizabeth A. Talbot, MD³, Cynthia Learson, RN², and Jose Montero, MD⁴. (1) Office of Workforce and Career Development, Centers for Disease Control and Prevention, NH DHHS, 29 Hazen Drive, Concord, NH 03301, (2) Bureau of Disease Control and Health Statistics, New Hampshire Department of Health and Human Services, 29 Hazen Drive, Concord, NH 03301, 603-271-4496, jsmanning@dhhs.state.nh.us, (3) New Hampshire Department of Health and Human Services, Bureau of Disease Control and Health Statistics, 29 Hazen Drive, Concord, NH 03301, (4) Division of Public Health Services, New Hampshire Department of Health and Human Services, 29 Hazen Drive, Concord, NH 03301

Background: In 2005, New Hampshire (NH) experienced an increase in reported acute hepatitis A (HA) infections compared with the previous 4 years. The majority of cases occurred among known or suspected illegal-drug users, a population not previously associated with HA in NH. We describe the outbreak and the NH Division of Public Health Services' (DPHS) public health response. Methods: NH DPHS staff conducted case investigations, identified contacts and recommended prophylaxis, created and distributed educational materials, and held vaccination clinics for illegal-drug users. Results: In 2005, 82 cases were reported, an increase from an annual mean of 19 reported cases during 2000–2004 (range: 12–27). Median age was 33 years (range: 4–61); 65% were male; 82% were white. Risk factors were identified for 78% of cases. The most common risk factors were being a known or suspected illegal-drug user (77% compared with 8% in 2004), and being a contact of a case (45%). Patients were from 33 cities, with 30% from one city. Fifty-two cases (63%) occurred during May–August. Public health response included collaboration with drug treatment centers to improve vaccination of illegal drug-users and organization of four vaccination clinics targeting illegal-drug users, in which 50 persons received HA vaccine. Since starting monthly vaccination clinics in July, the number of cases has decreased. During September–December, 13 cases occurred. Discussion: A majority of patients in this outbreak were known or suspected illegal-drug users. Targeting this population by continuing vaccination clinics and educational campaigns might prevent future outbreaks.

Learning Objectives:

• To describe an outbreak of hepatitis A among illegal-drug users
• To describe New Hampshire's response and interventions to control this outbreak and prevent disease

Keywords: Hepatitis A, Drug Use

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation