46 patients identified through August 31, 45 of whom are men who have sex with men (MSM)
Health Department recommends all MSM be vaccinated against hepatitis A
Targeted hepatitis A vaccine awareness campaign on dating apps, social media will be expanded
September 22, 2017 — The Health Department today is reporting 46 cases of hepatitis A among New York City residents who had sex with men or had sexual contact with men who have sex with men (MSM) between January 1 and August 31, 2017. Thirty-seven of the 46 patients reported no travel to countries where hepatitis A is prevalent. This is a significant increase over the last six years, when the Department identified an average of only three cases annually of hepatitis A infections among MSM who reported no travel to countries where this disease was prevalent. One of the cases was a female patient reporting sexual contact with a bisexual male. Fifteen of the 46 patients were hospitalized, and all patients have since recovered. Patients resided in all five boroughs and ranged in age from 19 to 55 years. Since June 2016, there have been ongoing outbreaks of hepatitis A among MSM in 16 Western European countries, and several US jurisdictions have reported unusual increases in cases or outbreaks of this disease. Hepatitis A is a vaccine-preventable disease that may have severe effects, especially in adults.
The Health Department recommends all MSM be vaccinated against hepatitis A. Of the 46 cases, only three patients with infection reported previously receiving a hepatitis A vaccine. Vaccines are available at many clinics and provider offices throughout New York City. For sexually active MSM who do not have a health care provider or have difficulty accessing immunization services, the City’s Sexual Health Clinics offer hepatitis A vaccines and other many sexual health services at low or no cost. Hepatitis A vaccine is also available for MSM at the City’s Immunization Clinic. Locations and hours of the various clinics can be found here.
“As we see this troubling rise in hepatitis A infections among men who have sex with men, we remind New Yorkers that this disease is easily preventable,” said Health Commissioner Dr. Mary T. Bassett. “Hepatitis A can potentially lead to long-term complications, but staying up-to-date with vaccinations is the best way to protect yourself and your fellow New Yorkers. Vaccinations are readily accessible and available at our Immunization Clinic and eight Sexual Health Clinics.”
“Hepatitis A is a vaccine-preventable disease,” said Dr. Demetre Daskalakis, Deputy Commissioner for the Health Department’s Division of Disease Control. “Men who have sex with men who are unvaccinated — and their providers — need to be alert to this emerging risk. The clear call to action is to get vaccinated as soon as possible. It’s just good healthcare to get this shot, especially in the setting of increasing transmission in our and other communities. If you can’t talk to your doctor about your sex life, don’t let that be a deterrent to taking care of your health. Visit nyc.gov/health/lgbtq to find an LGBTQ-knowledgeable provider near you.”
The Health Department will continue to promote hepatitis A vaccinations among MSM by using targeted messaging through dating applications and promoted social media. This summer, the Health Department launched a targeted marketing campaign, “It’s Just a Little Prick,” alerting MSM on social media of the increase of hepatitis A and urging them to get vaccinated. In October, the Department will roll out a new awareness and educational campaign targeting MSM users of dating apps and social media. Additionally, thousands of postcards were distributed during city Pride events and at the City’s Sexual Health Clinics.
In March, the Health Department released a Health Alert (PDF) to notify providers of an increase in hepatitis A cases among MSM in New York City. The Department will also follow up with another Health Alert to update providers on the current case count. A Health Advisory (PDF) was sent in June urging providers to vaccinate their MSM patients to prevent illnesses disproportionately affecting MSM, including hepatitis A. In August, the Health Department also issued a travel advisory for New Yorkers visiting Europe, including a recommendation for MSM to get vaccinated against hepatitis A.
“I thank the Department of Health for sounding the alarm on this disturbing trend, and encourage all at-risk New Yorkers to make use of our city’s public health resources and get vaccinated,” said Manhattan Borough President Gale A. Brewer.
"Knowledge and accessibility of care are essential in stopping the spread of STIs, particularly for hepatitis A,” said State Senator Brad Hoylman. “We need to make sure that New Yorkers, particularly men who have sex with men, are not only educated on the dangers of these STIs but are able to get treated. I'm grateful to Mayor de Blasio, DOHMH Commissioner Bassett, and Dr. Daskalakis for their continued efforts to improve the health and well-being of all New Yorkers."
“Hepatitis A is easily preventable by staying up-do-date on vaccinations, but cases in New York City show a persistent and disturbing increase, particularly among men who have sex with men,” said Assembly Health Committee Chair Richard N. Gottfried. “The City Health Department is right to focus on at-risk communities by expanding its efforts to alert New Yorkers to the risks of hepatitis A, using advertising and social media to spread the word about easy and affordable vaccinations available at any of the City’s sexual health or immunization clinics.”
"I urge all men who have sex with men to get vaccinated as soon as possible," said NYC Council Member Daniel Dromm (D-Jackson Heights, Elmhurst). "Hepatitis A is a serious disease and should not be taken lightly. The good news is that it is easily preventable. A vaccine is just a doctor's visit away. Those who do not have a health care provider whom they trust can obtain a vaccine by visiting a DOHMH Immunization Clinic or Sexual Health Clinic."
Since 1996, the Advisory Committee on Immunization Practices (ACIP) has recommended that all MSM receive two doses of hepatitis A vaccine; the second dose should be administered six to 12 months after the first dose. Evidence suggests that vaccination could provide immunity against hepatitis A for at least 25 years.
Hepatitis A is transmitted person-to-person through ingestion of contaminated food, water, or through sexual activities that result in exposure to stool. Among MSM, hepatitis A can be spread through direct anal-oral contact or contact with fingers or objects that have been in or near the anus of an infected person and contaminated with stool. The virus can be carried on an infected person’s hands when they do not practice good hand washing, resulting in contamination of food or drink they have handled. Proper hand washing with soap and water can prevent transmission. Symptoms include jaundice, fatigue, abdominal pain, nausea and diarrhea. People typically develop symptoms about one month after they are exposed to the virus. Not everyone who is infected will have all of these symptoms. Hepatitis A is rarely fatal, but it can cause severe disease that requires hospitalization and may result in death. People with chronic liver disease or a weakened immune system are more likely to experience severe disease. If a person thinks they may have hepatitis A, a doctor can check with a blood test. More information can be found here.
Sexual Health Clinics
This year, the Health Department announced the historic expansion of HIV and sexually transmitted infection (STI) services and the renaming of STD Clinics as Sexual Health Clinics. The expansion is part of the City’s Ending the Epidemic (ETE) plan, which includes $23 million in Fiscal Year 2018 and aims to reduce the number of new HIV infections in New York City to no more than 600 cases per year by 2020. The Sexual Health Clinics not only provide diagnosis and treatment for HIV and other STIs, they also provide services to prevent some STIs altogether—this includes vaccination for hepatitis A to eligible patients. Vaccination visits are also an important opportunity to offer screening for other STIs without having to see a clinician. Our services are fast and easy to access. Clinic services are available on a walk-in basis, six days per week, to anyone 12 years of age and above, without parental notification and without regard for ability to pay or immigration status. Call 311 or visit nyc.gov/health to find your nearest City Sexual Health Clinic.
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