Reports of hepatitis A infections increased by nearly 300% in the U.S. between 2016 and 2018 compared with 2013 to 2015, primarily due to outbreaks associated with contaminated food items, men who have sex with men, and people who report drug use or homelessness, according to the CDC.

Monique A. Foster, MD, and colleagues from the National Center for HIV, Viral Hepatitis, STD, and TB Prevention at the CDC, wrote that hepatitis A outbreaks previously occurred every 10 to 15 years and were associated with asymptomatic children.

“With the widespread adoption of universal childhood vaccination recommendations, asymptomatic children are no longer the main drivers of hepatitis A outbreaks,” they wrote. “Although the overall incidence rate of HAV infections has decreased within all age groups, a large population of susceptible, unvaccinated adults who were not infected by being exposed to the virus during childhood remain vulnerable to infection by contaminated foods ... and recently, on a much larger scale, through behaviors that increase risk for infection in certain vulnerable populations, such as drug use.” Read more via Healio