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Group of happy, unsuspecting peopleIn 2019, the DHHS Division of Public Health Services’ (DPHS) Bureau of Infectious Disease Control is seeing a marked increase of hepatitis A cases in New Hampshire. The Bureau of Infectious Disease Control is working with community partners to develop and implement effective practices to prevent the spread of hepatitis A in our state.

Since March 2017, the Centers for Disease Control and Prevention (CDC)’s Division of Viral Hepatitis (DVH) has been assisting several state and local health departments in addressing active hepatitis A outbreaks. These outbreaks are spread through person-to-person contact, primarily among individuals that reported experiencing homelessness or drug use (injection and non-injection).

Hepatitis A Virus (HAV) Investigation Summary Report
November 1, 2018- March 19, 2019

Number of Illnesses Investigated Total Hepatitis A Map
Total Number of HAV Infections Identified 53
33 (62%)
0 (0%)
Reported County of Confirmed Cases  
Hillsborough 24
Strafford 13
Rockingham 9
Merrimack 4
Cheshire 1
Grafton 1
Sullivan 1

Preventative Outbreak Response

The State has identified response activities necessary to prevent and/or contain an outbreak among at-risk populations. These at-risk populations include, but are not limited to:

  • Gay and bisexual men (men who have sex with men)
  • Persons who use recreational drugs, including both injection and non-injection drugs. This can include persons with substance use disorders.
  • Persons experiencing homelessness and with unstable housing (e.g. “couch surfing”)

The Advisory Committee on Immunization Practices (ACIP) also recommends hepatitis A vaccination for any person wishing to obtain immunity (protection) regardless of risk. The hepatitis A vaccine is a very safe and effective vaccine.

Hepatitis A Frequently Asked Questions

  • What is hepatitis A?
    Hepatitis A is a highly contagious liver infection caused by the hepatitis A virus. It can range from a mild illness lasting a few weeks to a severe illness lasting several months. Although rare, hepatitis A can cause death in some people. Hepatitis A usually spreads when a person unknowingly ingests the virus from objects, food, or drinks contaminated by small, undetected amounts of stool from an infected person.
  • How serious is hepatitis A?
    Most people who get hepatitis A feel sick for several weeks, but they usually recover completely and do not have lasting liver damage. In rare cases, hepatitis A can cause liver failure and death; this is more common in people older than 50 and in people with other liver diseases.
  • Are you at risk?
    Although anyone can get hepatitis A, in the United States, certain groups of people are at higher risk, such as:
    • People with direct contact with someone who has hepatitis A
    • Travelers to countries where hepatitis A is common
    • Men who have sexual contact with men
    • People who use drugs, both injection and non-injection drugs
    • Household members or caregivers of a recent adoptee from countries where hepatitis A is common
    • People with clotting factor disorders, such as hemophilia
    • People working with nonhuman primates
    • Persons experiencing homelessness and with unstable housing (e.g. “couch surfing”)
  • What are the symptoms of hepatitis A?
    Older children and adults typically have symptoms. If symptoms develop, they can appear abruptly and can include:
    • Fever
    • Fatigue
    • Loss of appetite
    • Nausea
    • Vomiting
    • Abdominal pain
    • Dark urine
    • Diarrhea
    • Clay-colored stools
    • Joint pain
    • Jaundice (yellowing of the skin and eyes)

    Most children younger than age 6 do not have symptoms when they have hepatitis A. When symptoms are present, young children typically do not have jaundice but most older children and adults with hepatitis A have jaundice.

  • Who is recommended to receive the hepatitis A vaccine?
    The vaccine is recommended for:
    • All children starting at one year of age and older
    • People who are at increased risk of hepatitis A infection (as noted above)
    • Those with chronic liver diseases (such as hepatitis B and hepatitis C infections)
    • Anybody wishing to obtain immunity
  • Where can I receive the hepatitis A vaccine?
    Contact your medical provider or visit one of the following:
    • Nashua Public Health Department
      18 Mulberry Street
      Nashua, NH 03060
      Tuesday: 4:00pm to 7:00pm
      Friday: 8:30am to 10:30am
      Call: (603) 589-4500
    • Manchester Health Department
      1528 Elm Street
      Manchester, NH 03101
      Monday: 1:30pm to 3:30pm
      Tuesday: 9:00am to 11:30am
      Thursday: 3:00pm to 6:00pm
      Call: (603) 624-6466
    • Goodwin Community Health
      311 NH-108
      Somersworth, NH 03878
      Wednesday: 1:30pm to 4:00pm
      Call: (603) 749-2346
    • Concord Regional VNA
      St. Paul’s Episcopal Church
      21 Centre Street
      Concord, NH 03301
      1st Monday of each month: 1:00pm to 4:00pm
      Call: (603) 224-4093

If you reside outside of the listed areas, call the Immunization Program at (603) 271-4482.


Any suspect or confirmed case of hepatitis A should be reported to DPHS within 24 hours by calling 603-271-4496; after hours, please call 603-271-5300.

If you are a medical or community provider seeking assistance, please contact us additional guidance:

  • Phone: 603-271-4496
  • Fax: 603-271-0545

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New Hampshire Department of Health and Human Services
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