Taking Immunizations to the Streets To Stop Hepatitis A

Taking Immunizations to the Streets To Stop Hepatitis A

Taking Immunizations to the Streets To Stop Hepatitis A

Starting in late 2016, communities across the United States began reporting a surge in cases of hepatitis A—with more than 22,000 cases reported nationwide by July 2019. While parts of the country continue to battle this outbreak, Utah declared its outbreak over in February 2019 (after nearly 300 cases), thanks in part to innovative approaches used by the Salt Lake County Health Department (SLCoHD). About 200 of Utah’s cases occurred in that county, and most of those cases were among persons who were experiencing homelessness or using illicit drugs, making it more challenging to provide treatment.

SLCoHD used a variety of inventive methods to reach the sources of infection in the region and stop the outbreak—

• Partnered with a local nonprofit syringe exchange program that was trusted by the drug community
• Developed mobile immunization teams (e.g., on foot, using backpacks)
• Immunized people at area homeless shelters
• Partnered with local hospitals to create a protocol outlining how to discharge a contagious homeless person from hospital care
• Sent food inspectors to restaurants and convenience stores where bathroom facilities were close to known homeless encampments to teach them how to sanitize against the virus
• Reinforced the importance of immunizations for food service workers, even creating a temporary amendment to the food code; the amendment required an employee who was exposed to hepatitis A to be vaccinated within 14 days of exposure or the employee would be excluded from work for 28 days.

SLCoHD’s efforts were so effective that the temporary amendment to the food code was adopted into local food regulations in May 2018. For its exemplary efforts, SLCoHD was recognized by NACCHO during its 2019 annual conference as one of the “Large Health Departments of the Year.” The award honors local health departments that had “outstanding achievements in demonstrating innovative ways to improve public health and safety.”

For more information about this initiative and to read other highlights from the field, visit Field Notes on CDC’s Public Health Professionals Gateway.