{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:26:34Z","timestamp":1787840794790,"version":"build-2784847793"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>During 2016\u20132023, 37 U.S. states experienced hepatitis A outbreaks associated with person\u2010to\u2010person transmission. We sought to describe the epidemiology of the outbreaks and characterise outbreak response efforts over time. We analysed outbreak databases from 37 states, survey responses from 33 states, and hepatitis A case reports from the National Notifiable Diseases Surveillance System for all 50 states and Washington, DC, during August 1, 2016\u2013December 31, 2023. Among 44,930 reported outbreak\u2010associated cases, most occurred among males (62%), non\u2010Hispanic White persons (65%), and those aged 30\u201349\u2009years (54%); 62% were hospitalised and 1% died. Commonly reported risk factors for HAV infection were drug use (53%) and homelessness or unstable housing (14%). Sixty\u2010seven percent of adults had a documented indication for hepatitis A vaccination. In late 2017, CDC stood up a national incident management system to coordinate communication between outbreak\u2010affected states, facilitate vaccine delivery, and provide technical assistance. States with available data reported administering more than 5.3 million adult hepatitis A vaccines collectively; most states administered vaccines in correctional facilities, local health departments and homeless shelters. Outbreak\u2010associated cases peaked in 2019 and then declined annually. As outbreak response capacity scaled up nationwide, states with later outbreak start dates tended to experience smaller outbreaks than those with earlier start dates. Unprecedented hepatitis A outbreaks were controlled by a robust vaccine response in 37 states. Continued vigilance and providing access to vaccination for recommended populations will be critical to preventing similar outbreaks in the future.<\/jats:p>","DOI":"10.1111\/jvh.70137","type":"journal-article","created":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T11:07:49Z","timestamp":1769252869000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Epidemiology and Control of Widespread Community Hepatitis A Outbreaks in 37 U.S. States, 2016\u20132023"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9186-1687","authenticated-orcid":false,"given":"Megan G.","family":"Hofmeister","sequence":"first","affiliation":[{"name":"Division of Viral Hepatitis Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoman","family":"Yin","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Dokpesi","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyasu H.","family":"Teshale","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maribeth","family":"Eckert","sequence":"additional","affiliation":[{"name":"Immunization Services Division Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Hepatitis A Outbreak Investigation Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,24]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0891\u20105520(05)70123\u20109"},{"issue":"15","key":"e_1_2_10_3_1","first-page":"1","article-title":"Prevention of Hepatitis A Through Active or Passive Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"45","year":"1996","journal-title":"MMWR \u2010 Recommendations and Reports"},{"issue":"12","key":"e_1_2_10_4_1","first-page":"1","article-title":"Prevention of Hepatitis A Through Active or Passive Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"48","year":"1999","journal-title":"MMWR \u2010 Recommendations and Reports"},{"issue":"7","key":"e_1_2_10_5_1","first-page":"1","article-title":"Prevention of Hepatitis A Through Active or Passive Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"55","author":"Fiore A. E.","year":"2006","journal-title":"MMWR \u2010 Recommendations and Reports"},{"issue":"41","key":"e_1_2_10_6_1","first-page":"1080","article-title":"Updated Recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"56","author":"Update: Prevention of Hepatitis A After Exposure to Hepatitis A Virus and in International Travelers","year":"2007","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"issue":"36","key":"e_1_2_10_7_1","first-page":"1006","article-title":"Updated Recommendations From the Advisory Committee on Immunization Practices (ACIP) for Use of Hepatitis A Vaccine in Close Contacts of Newly Arriving International Adoptees","volume":"58","year":"2009","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr6905a1"},{"key":"e_1_2_10_9_1","unstructured":"Centers for Disease Control and Prevention. Viral Hepatitis Surveillance \u2013 United States(2024) https:\/\/www.cdc.gov\/hepatitis\/statistics\/SurveillanceRpts.htm."},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7139a1"},{"key":"e_1_2_10_11_1","unstructured":"Centers for Disease Control and Prevention \u201cHepatitis A Outbreak Linked to Person\u2010to\u2010Person Contact \u201d(2024) https:\/\/www.cdc.gov\/hepatitis\u2010a\/outbreaks\/person\u2010to\u2010person\/index.html."},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6743a3"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/00333549231184007"},{"key":"e_1_2_10_14_1","unstructured":"Centers for Disease Control and Prevention \u201cHepatitis A Acute \u201d(2021) https:\/\/ndc.services.cdc.gov\/conditions\/hepatitis\u2010a\u2010acute\/."},{"key":"e_1_2_10_15_1","unstructured":"Centers for Disease Control and Prevention \u201cNational Notifiable Diseases Surveillance System (NNDSS) \u201dhttps:\/\/www.cdc.gov\/nndss\/index.html."},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2605.191224"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2021.09.051"},{"key":"e_1_2_10_18_1","unstructured":"Appalachian Regional Commission \u201cAbout the Appalachian Region \u201dhttps:\/\/www.arc.gov\/about\u2010the\u2010appalachian\u2010region\/."},{"key":"e_1_2_10_19_1","unstructured":"NORC at the University of ChicagoandEast Tennessee State University \u201cAppalachian Diseases of Despair \u201dhttps:\/\/www.arc.gov\/wp\u2010content\/uploads\/2023\/01\/Appalachian\u2010Diseases\u2010of\u2010Despair\u2010Update\u2010November\u20102022.pdf."},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.2105\/ajph.2021.306308"}],"container-title":["Journal of Viral Hepatitis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jvh.70137","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jvh.70137","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jvh.70137","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T15:27:24Z","timestamp":1770910044000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jvh.70137"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,24]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1111\/jvh.70137"],"URL":"https:\/\/doi.org\/10.1111\/jvh.70137","archive":["Portico"],"relation":{},"ISSN":["1352-0504","1365-2893"],"issn-type":[{"value":"1352-0504","type":"print"},{"value":"1365-2893","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,24]]},"assertion":[{"value":"2025-05-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70137"}}