{"doi":"10.1093/infdis/jiaa636","title":"Hepatitis A Person-to-Person Outbreaks: Epidemiology, Morbidity Burden, and Factors Associated With Hospitalization—Multiple States, 2016–2019","abstract":"BACKGROUND: Since 2016, the United States has experienced person-to-person hepatitis A outbreaks unprecedented in the vaccine era. The proportion of cases hospitalized in these outbreaks exceeds historical national surveillance data. METHODS: We described the epidemiology, characterized the reported increased morbidity, and identified factors associated with hospitalization during the outbreaks by reviewing a 10% random sample of outbreak-associated hepatitis A cases in Kentucky, Michigan, and West Virginia-3 heavily affected states. We calculated descriptive statistics and conducted age-adjusted log-binomial regression analyses to identify factors associated with hospitalization. RESULTS: Participants in the random sample (n = 817) were primarily male (62.5%) with mean age of 39.0 years; 51.8% were hospitalized. Among those with available information, 73.2% reported drug use, 14.0% were experiencing homelessness, 29.7% were currently or recently incarcerated, and 61.6% were epidemiologically linked to a known outbreak-associated case. Residence in Michigan (adjusted risk ratio [aRR] = 1.8), being a man who has sex with men (aRR = 1.5), noninjection drug use (aRR = 1.3), and homelessness (aRR = 1.3) were significantly (P < .05) associated with hepatitis A-related hospitalization. CONCLUSIONS: Our findings support current Advisory Committee on Immunization Practices recommendations to vaccinate all persons who use drugs, men who have sex with men, and persons experiencing homelessness against hepatitis A.","journal":"The Journal of Infectious Diseases","year":2020,"id":91237,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":46,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8957,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":342294,"name":"Jian Xing","orcid":"0000-0003-1114-7019","position":1,"is_corresponding":false},{"id":342295,"name":"Monique A. Foster","orcid":"0000-0002-9088-5281","position":2,"is_corresponding":false},{"id":343401,"name":"Ryan J. Augustine","orcid":null,"position":3,"is_corresponding":false},{"id":343402,"name":"Cole Burkholder","orcid":null,"position":4,"is_corresponding":false},{"id":343403,"name":"Jim Collins","orcid":null,"position":5,"is_corresponding":false},{"id":343404,"name":"Shannon McBee","orcid":null,"position":6,"is_corresponding":false},{"id":343405,"name":"Erica D. Thomasson","orcid":null,"position":7,"is_corresponding":false},{"id":342296,"name":"Douglas Thoroughman","orcid":"0000-0003-1150-1268","position":8,"is_corresponding":false},{"id":342297,"name":"Mark K. Weng","orcid":"0000-0002-7902-2602","position":9,"is_corresponding":false},{"id":342298,"name":"Philip R. Spradling","orcid":"0000-0001-7609-0485","position":10,"is_corresponding":false},{"id":342293,"name":"Megan G. Hofmeister","orcid":"0000-0002-9186-1687","position":0,"is_corresponding":true}],"reference_count":21,"raw_metadata":null,"created_at":"2026-07-18T22:28:45.409789Z","pmid":"33097935","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}