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Hepatitis A virus infects the liver and can cause illnesses that range from a mild infection that has no symptoms to a more severe illness that can last for months. In rare occasions, it can cause liver failure and death.

Hepatitis A virus spreads easily. It gets into the body through the mouth after someone touches an object, food, or drink that is contaminated with the virus. If an infected person doesn’t wash their hands well, especially after using the toilet, undetectable amounts of the virus can spread from the hands of that person to other objects, surfaces, and foods. Most cases occur through eating contaminated food.

Current case numbers
Confirmed cases linked to our hepatitis A outbreak among people who are living homeless, who use drugs, or who have a matching strain of the virus: 4
All other confirmed hepatitis A cases in 2019: 14

Resources for the general public

Common symptoms include:

  • Tiredness
  • Nausea
  • Vomiting
  • abdominal pain
  • loss of appetite
  • low-grade fever
  • yellow discoloration of the whites of the eyes and skin (jaundice)
  • clay-colored bowel movements
  • dark urine
  • joint pain

Some people get infected with hepatitis A but do not experience all (or any) of these symptoms.

People who are at highest risk are:

  • People living homeless, especially those living unsheltered without good access to sanitation, hygiene and handwashing facilities
  • People who are living with or caring for a person who already has hepatitis A
  • People who have sex with people with hepatitis A
  • Men who have sex with men
  • People who use street drugs
  • People with clotting disorders like hemophilia
  • International travelers
  • People with chronic liver disease, including hepatitis B and hepatitis C are at increased risk for severe infections

Hepatitis A vaccination is the best way to prevent hepatitis A. The shot is safe and effective; anyone who wants to reduce their risk of hepatitis A should get vaccinated. Anyone who is in the higher risk groups should be sure to get the hepatitis A vaccine to protect themselves.

Hepatitis A vaccinations can also be used to help prevent illness from hepatitis A among those who may have been exposed to the virus if given within two weeks of exposure.

Practicing good hand hygiene – including thoroughly washing hands after using the bathroom, changing diapers, and before preparing or eating food – also plays an important role in preventing the spread of hepatitis A. People in high risk groups should also avoid sharing food, drinks, drug equipment (works), and other personal items.

To get a hepatitis A vaccine, visit your doctor, nurse, or clinic. You can also check for pharmacies that offer hepatitis A vaccine. Check our Healthcare for the Homeless Network page for information about vaccination locations for people living homeless or people who use street drugs.

Resources for specific groups

For people living homeless and homeless service providers:

Guidelilnes on cleaning to kill Hepatitis A

Free hepatitis A vaccination locations for people living homeless

Hepatitis A: Health warning and free vaccine sites for people living homeless in:

Cleaning to kill Hepatitis A

For men who have sex with men (MSM):
Purpose of surveillance:
  • To identify persons exposed to cases of hepatitis A so that preventive treatment can be administered
  • To identify common source outbreaks
  • To identify and eliminate sources of transmission including contaminated food and water
Local epidemiology:

Fourteen cases of hepatitis A were reported in 2018 compared to a ten-year average of 11 cases per year. Among 2018 cases, 7 (50%) were hospitalized for their illness. The last reported death associated with hepatitis A occurred in 2013.

Five cases in 2018 reported international travel prior to onset of illness, specifically travel to India (2), Costa Rica (1), Egypt (1) and Mexico (1).

Since the introduction of the hepatitis A vaccine in 1995, the number of hepatitis A cases reported have progressively declined locally and nationally. However, after a long downward trend, the number of infections in the U.S. has fluctuated since 2012 due to large outbreaks. Each year, between 21 and 45 cases of hepatitis A are reported statewide in Washington.

Hepatitis A case data

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