Background: Illegal drug use, injection and non-injection, is a known risk factor for Hepatitis A. In 1999, the Advisory Committee on Immunization Practices (ACIP) recommended that illegal drug sharing partners (DSP) of Hepatitis A patients receive both postexposure prophylaxis (PEP) with immune globulin and Hepatitis A vaccination. We assessed how states identify illegal drug users with Hepatitis A, and use PEP and vaccine. Methods: We performed a cross-sectional telephone survey of 31 states with the highest rates of Hepatitis A. States were asked what investigation form they use to identify risk factors for Hepatitis A and what criteria they use to determine who receives PEP and vaccine. Results: Twenty-five (80%) of 31 states use the CDC-Viral Hepatitis Surveillance Program (VHSP) form to assess risk factors and list PEP contacts. This form includes only one question about injection drug use and none about other drug use. Only one state has a written policy about giving PEP to DSP though most states would consider it. Several states have used PEP outreach programs for drug users during outbreaks; however, none do so regularly. Only two states have limited Hepatitis A vaccination programs for illegal drug users; neither in a postexposure setting. Conclusions: By relying on the CDC-VHSP states may underestimate the number of drug-associated Hepatitis A cases in baseline and outbreak conditions. Few states have policies or protocols for following ACIP recommendations for illegal drug users and their DSP. Thus DSP of Hepatitis A patients may be at high risk of secondary disease.
Learning Objectives: At the end of this session the participants will be able to: 1) Describe the burden of drug associated hepatitis A and ACIP recommendations. 2) Understand how states assess drug use in cases of hepatitis A. 3) Describe the policies of states regarding hepatitis A vaccination and prophylaxis in the drug using community. 4) Develop a comprehensive hepatitis A vaccine program
Keywords: Hepatitis A, Drug Injectors
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Centers for Disease Control and Prevention,
State Health Departments,
Advisory Committee on Immunization Practices (ACIP)
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I am a CDC Epidemic Intelligence Service Officer. My abstract relates how state health departments use CDC forms. I am currently assigned to Los Angeles County and the abstract will, in part, present the policies of Los Angeles County.