Hepatitis A outbreak ends in Alabama; vaccine is effective in reducing risk


CONTACT: Wes Stubblefield, M.D., (256) 340-2113

Alabama is one of 22 states in which hepatitis A is no longer considered to be in outbreak status. Hepatitis A is a serious liver disease caused by the hepatitis A virus and usually spread through close personal contact or when a person unknowingly ingests the virus from contaminated objects, food or drinks.

The outbreak began in September 2018 after a rise in cases, especially among northeastern Alabama residents. The outbreak peaked in September 2020 and the incidence of cases has since decreased. There have been 1,681 cases reported during the past four years and 1,177 hospitalizations.

The Alabama Department of Public Health (ADPH) defines an outbreak as the occurrence of more cases of disease than expected in a given area or among a specific group of people over a particular period of time linked to a common exposure.

Symptoms of hepatitis A usually occur 28 days after getting the virus, and may include the following:

  • Fever
  • Dark urine
  • Feeling tired
  • Light-colored stools
  • Decreased appetite
  • Joint pain
  • Nausea and/or vomiting
  • Yellowing of skin or eyes (jaundice)
  • Stomach pain or discomfort

The hepatitis A vaccine is the best way to prevent infection with the very contagious virus. The Advisory Committee on Immunization Practices recommends routine vaccination of children aged 12-23 months and catch-up vaccination for children and adolescents 2-18 years who have not previously received hepatitis A vaccine at any age. Adults who were not vaccinated previously and want to be protected against hepatitis A can also get the vaccine.

Hepatitis A vaccine is recommended for the following:

  • International travelers
  • Men who have sexual contact with other men
  • People who use injection or non-injection drugs
  • People who have occupational risk for infection
  • People who anticipate close contact with an international adoptee
  • People experiencing homelessness
  • People with HIV
  • People with chronic liver disease
In addition, a person who has not previously received hepatitis A vaccine and who has direct contact with someone with hepatitis A should get hepatitis A vaccine as soon as possible and within two weeks after exposure.

To reduce the risk of hepatitis A disease:

  • Get vaccinated.
  • Wash hands after using the bathroom, before preparing or eating meals, and after touching anything unclean.
  • Do not share food, drinks, eating utensils, cigarettes, towels, toothbrushes or drug paraphernalia.
  • Avoid oral and anal sex.
In the past four years 29,000 adults have received the hepatitis A vaccine. Public health employees have administered vaccinations at various locations including jails. Patrons of restaurants where there has been an infected food handler have been informed that they should be vaccinated as a precaution.

For more information, go to alabamapublichealth.gov/immunization/hepatitis_a.html



County health departments throughout Alabama provide a wide range of confidential and professional services. Contact your local county health department for additional information.

Mission: To promote, protect, and improve Alabama’s health

Vision: Healthy People. Healthy Communities. Healthy Alabama.