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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- November 5, 2019

Number of Illnesses Investigated Total
Total Number of HAV Infections Identified 264
Hospitalized 161 (61%)
Deaths 2 (<1%)
Reported County of Confirmed Cases  
Belknap 8 (3%)
Carroll 3 (1%)
Cheshire 3 (1%)
Coos 4 (1%)
Grafton 4 (1%)
Hillsborough 118 (45%)
Merrimack 44 (17%)
Rockingham 26 (10%)
Strafford 52 (20%)
Sullivan 2 (1%)

Hep A Chart

Hepatitis A Map

Preventative Outbreak Response

The State has identified response activities necessary to prevent and/or contain an outbreak among at-risk populations (as noted below in “Who is recommended to receive the hepatitis A vaccine?”).

Who is recommended to receive the hepatitis A vaccine?
The following individuals are currently at greatest risk of getting hepatitis A infection and developing serious complications due to hepatitis A infection and are encouraged to seek out hepatitis A vaccine as soon as possible:

  • People with substance use disorder (specifically people who use injection and/or non-injection drugs)
  • People experiencing homelessness or unstable housing
  • Gay and bisexual men
  • People who are, or were recently, incarcerated
  • People with chronic liver disease, including cirrhosis, hepatitis B, or hepatitis C

The following individuals should also be vaccinated:

  • All children starting at one year of age and older
  • Any person wishing to obtain immunity

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.

  • 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. When symptoms are present, young children typically do not have jaundice but most older children and adults with hepatitis A have jaundice.

  • What can I do to prevent the disease?
    The best ways to prevent hepatitis A are with the hepatitis A vaccine and proper hand hygiene. It is always best to thoroughly wash hands after using the bathroom, changing diapers, and before preparing or eating food.

  • Where can I receive the hepatitis A vaccine?
    Contact your healthcare provider or go to your local pharmacy.

    If you are uninsured or underinsured you may also get Hepatitis A vaccine at one of the following clinics:
    • 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

  • What should I do if I have symptoms?
    Anyone who has symptoms should contact a healthcare provider immediately and should not prepare food for others. People with symptoms should not attend work or school while ill.

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

Resources

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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