PHILADELPHIA–Less than six months after declaring an outbreak of Hepatitis A to be a public health emergency, the Philadelphia Department of Public Health has released a report on the response showing that, after an intensive vaccination campaign and the installation of public toilets, the city experienced a greater than 90% drop from a peak of nearly 120 Hepatitis A cases in August 2019 to fewer than 10 cases in December 2019.

The outbreak occurred mostly in 2019.  After seeing fewer than 10 cases per year between 2011 and 2016, the Health Department saw an increasing number of cases, culminating in 426 outbreak-related cases in 2019. The majority of these cases (329) were reported between June and September 2019.

In August 2019, the Health Department began a campaign to provide free Hepatitis A vaccines to people in at-risk populations, including injection drug users, those experiencing homelessness, and those living in higher-risk areas like Kensington. 12,442 vaccinations per provided as part of this response in 2019. In September, the City installed public toilets and handwashing stations in Kensington. New cases of Hepatitis A dropped precipitously beginning in September and continued through the end of the year: 50 cases in September, 36 cases in October, 15 cases in November, nine cases in December.

Health Commissioner Dr. Thomas Farley said, “The most successful strategy to combat these outbreaks is an intensive vaccination campaign, which we’ve implemented and appears to have worked. While we are excited to see these results, there is much more work to be done to ensure that the infection does not flare up again.”

Vaccines have been distributed through a variety of partners. In addition to pop-up vaccine clinics at places like McPherson Square and SEPTA’s Frankford and Arrott Transportation Centers, the Health Department worked with trusted partners to ensure that there were many ways for people living at-risk to get access to the vaccine.

• The Philadelphia Department of Prisons provided 4,310 vaccinations to prisoners.
• Hospital emergency departments provided 3,000 vaccinations to patients determined to be at-risk.
• Prevention Point Philadelphia hosted a contract nurse to administer vaccinations inside their drop-in center for several months.
• Recovery and addiction services centers, and homeless shelters and soup kitchens provided on-site vaccination clinics for both clients and staff.

In addition to vaccinations, the City provided nearly 7,000 hygiene kits to high-risk individuals and over 30 city and community partner agencies that serve high-risk populations, including the Office of Homeless Services and the Department of Behavioral Health and Intellectual disAbility Services. Kit materials included hand sanitizer, soap, antimicrobial body wipes, waste bags, and condoms, among other items, as well as wallet-sized pamphlets on hepatitis A prevention and opioid addiction resources. The City also opened two public restroom trailers and a handwashing station in Kensington to stop the spread of the disease caused by contact with feces. The restrooms were used 21,351 times over a nine-week period.

The Health Department is continuing this work given the higher prevalence of hepatitis A in the city, and in accordance with CDC recommendations. Vaccinations will continue to be provided through collaboration with partner agencies and healthcare providers. Additionally, to prevent future outbreaks, the Health Department will continue to promote community-based sanitation measures in the highest-risk area.

The full Hepatitis A Outbreak Response report and the latest data on the Hepatitis A outbreak can be found on the Health Department’s Health Information Portal.