Indiana Hepatitis A Outbreak

Since November 2017, the Indiana State Department of Health (ISDH) has been investigating an outbreak of acute hepatitis A virus (HAV). Cases have been infected with HAV strains genetically linked to outbreaks across the United States. Indiana has an average of 20 cases of hepatitis A per 12 month period.

Indiana is one of several states experiencing a hepatitis A outbreak, and outbreak-related cases have been confirmed across the state. Information on other outbreaks can be accessed from the Centers for Disease Control and Prevention (CDC) website. Transmission is presumed to occur person to person; no contaminated commercial food product has been identified. Based on CDC guidelines, populations who are homeless, transient, incarcerated or use illicit drugs and their close direct contacts are considered at increased risk of exposure to hepatitis A.

If you believe you have been exposed to hepatitis A or are homeless, use injection or non-injection drugs, were recently incarcerated, or had contact with someone who has hepatitis A, contact your healthcare provider about hepatitis A vaccine.

To reduce the risk of hepatitis A transmission, people who have not received two doses of hepatitis A vaccine may ask their healthcare providers for protection. Additionally, always wash your hands with soap and water after going to the bathroom, after changing diapers and before preparing meals for yourself and others. Do not attend work or school if you are experiencing symptoms of hepatitis A, which include nausea, vomiting, diarrhea, loss of appetite, tiredness, stomach ache, fever, dark-colored (cola) urine, light-colored stool and jaundice (yellowing of skin and eyes). Symptoms may take as many as 50 days from exposure to appear.

Using the outbreak definition* (see below), the ISDH will update this website each Friday to reflect counties that have five or more outbreak-related cases. The ISDH updated the outbreak definition on 7/20/2018 and may reflect additional cases that were not included in previous outbreak case counts.

*Indiana outbreak case definition: confirmed hepatitis A cases (hepatitis A IgM positive with acute symptom onset AND either jaundice OR elevated liver enzymes) acquired since Nov. 1, 2017, through person to person transmission within the United States. Cases may be excluded from the outbreak if a confirmed case has no known risk factors (illicit drug use, homelessness, incarceration, men who have sex with men, contact with a confirmed case or domestic travel to an area with a known outbreak), AND has traveled outside of the United States to a country with endemic hepatitis A OR if a confirmed case has a specimen identified as any genotype (laboratory test link) other than 1B.

Hepatitis A Outbreak Resources


Page last updated: September 13, 2018