BOSTON — The Massachusetts Department of Public Health announced on Monday that 65 Massachusetts residents experiencing homelessness and/or substance use disorder statewide have recently acquired acute hepatitis A infection, a viral infection that affects the liver and can cause severe illness. One person has died as a result of their infection.

DPH also today issued a public health alert about the hepatitis A outbreak, encouraging local health departments to work with clinical and community-based agencies providing services to people experiencing homelessness and those with substance use disorder, especially those injecting drugs, to educate them about the health risks and to offer vaccine.

Of the 65 hepatitis A cases, 45 percent are located in Boston with an increasing number in other cities and towns, including the Southeast and metro Boston areas. In early August, DPH and the Boston Public Health Commission issued a clinical advisory when it became apparent that there was ongoing transmission occurring among residents experiencing homelessness and/or substance use disorder. Most of those affected in Massachusetts and elsewhere also have evidence of hepatitis C, a blood-borne infection highly associated with injection drug use, making their illness more severe.

Hepatitis A is transmitted primarily through fecal-oral contact that can be associated with living in unsanitary conditions and poor hygiene. Symptoms include fever, fatigue, loss of appetite, stomach pain, nausea, diarrhea, and jaundice (yellowing of the skin and eyes), grey stools, and dark urine.

DPH has been working with clinicians statewide and local health departments, including the Boston Public Health Commission, to increase awareness of this outbreak among people who use substances and/or are experiencing homelessness and urging vaccination through homeless outreach services, shelters, community health centers, hospitals, and other facilities.

Massachusetts Department of Public Health