The rate of deaths reported from hepatitis A virus (HAV) in the United States nearly doubled from 2016 to 2022 compared with the previous six years, according to a Centers for Disease Control and Prevention (CDC) report. What’s more, those who use drugs or experience unstable housing or homelessness are most at risk.

HAV is an acute form of hepatitis, meaning that it does not cause chronic, or long-term, infection. It is spread from one person to another when the fecal matter of someone with HAV gets into another person’s mouth, which can happen in a number of ways, including eating food handled or prepared by someone with hepatitis A. If you have had HAV once, you cannot be infected with the virus again. However, you can still be infected with other hepatitis viruses, such as hepatitis B virus and hepatitis C virus.

Since 2016, person-to-person HAV transmission has contributed to outbreaks in 37 states. There have been about 44,900 cases, 27,450 hospitalizations and 423 deaths as of October 2023, according to report author Megan Hofmeister, MD, of the CDC’s National Center for HIV, Viral Hepatitis, STD and TB Prevention.

Utilizing data from 27 states, which accounted for 315 outbreak-related deaths, the CDC report found that the average age of death was 55 years. The most deaths were reported among men (73%) and non-Hispanic white people (84%). Deaths peaked in 2019 and decreased annually through 2022, according to the report.

Drug use was the most commonly reported risk factor for HAV infection (41%), followed by homelessness or unstable housing (16%). Authors note that HAV may disproportionately affect people who use drugs or experience homelessness because of a lack of access to sanitation, poor hygiene or crowded living conditions.

“As of October 2023, 34 states have declared ends to their outbreaks; however, many susceptible adults, particularly among persons who use drugs, persons experiencing homelessness and persons with chronic liver disease, remain at increased risk for HAV infection or severe disease from HAV infection,” Hofmeister and colleagues wrote. “Increased hepatitis A vaccination coverage is critical to maintain the progress that has been made and prevent future hepatitis A deaths.”

To view the full CD report, go here.

To learn more, click #Hepatitis A or Health Basics on Hepatitis A. It reads in part:

Not everyone who contracts hepatitis A virus will experience noticeable symptoms. For example, many babies and young children with HAV do not experience any symptoms of infection. Symptoms are much more likely to occur in older children, adolescents and adults. 


Symptoms of hepatitis A (and acute hepatitis in general) can include:

—Yellowing of the skin, whites of the eyes and under the fingernails (jaundice)

—Feeling tired and rundown (fatigue)

—Pain in the upper-right abdomen

—Loss of appetite

—Weight loss





—Dark urine and/or pale stool

—Joint pain.

It can take the immune system up to eight weeks to clear HAV from the body. If symptoms occur, they usually do so within two to four weeks after infection. The symptoms of hepatitis A can last anywhere from a week to more than a month. About 15% of people with hepatitis A experience symptoms that last between six to nine months.


The usual treatment for hepatitis A is bed rest. It is also important to drink plenty of fluids, particularly if you are experiencing diarrhea or vomiting. Over-the-counter pain relievers, such as ibuprofen (Advil, Motrin, etc.), can help manage some of the symptoms of hepatitis A, although it’s best to consult with your health care provider before using any medications.