A successful targeted vaccine campaign prevented a hepatitis A outbreak in a Los Angeles County jail, according to a study yesterday in Morbidity and Mortality Weekly Report.
On May 30, 2023, the Los Angeles County Jail system was notified that an inmate had received a positive hepatitis A test result, the authors said. The person was a 41-year-old food handler who had been first jailed on April 27, 2023, who reported homelessness, injection drug use, and alcohol use disorder on intake. The patient complained of severe abdominal pain and, upon clinical examination, showed signs of jaundice.
An investigation using electronic health records and immunization history helped identify prison contacts who were eligible for hepatitis A vaccination.
Vaccination began within 48 hours
Within 48 hours, 2,766 persons were offered vaccine, and 1,510 (54.6%) agreed to receive it.
"Contacts who were food handlers without confirmed evidence of immunity and who declined vaccination were removed from food-handling duties for the duration of their potential incubation period," the authors wrote.
No additional cases were identified.
"This exposure response highlights the importance of initiating a rapid response to hepatitis A exposure in a jail setting to minimize risk for transmission and help prevent an outbreak," the authors wrote.
"The prompt vaccine rollout likely helped reduce transmission and prevent an outbreak among the LACJ population, and the enhanced surveillance, which included the monitoring of emergency hospital transfers made because of suspicion of acute hepatitis A, helped identify possible secondary cases or clusters needing further investigation"
