Notification from the Los Angeles County Department of Public Health
Notification from the Los Angeles County Department of Public Health
LAC DPH Health Alert:
Public Health Declares Communitywide Outbreak of Hepatitis A in Los Angeles County
May 5, 2025
This message is intended for all healthcare providers.
Please distribute as appropriate.
Key Messages
  • Los Angeles County Department of Public Health (LAC DPH) is declaring a communitywide outbreak of hepatitis A.
  • Most 2025 hepatitis A cases have occurred in people without typical risk factors such as travel, unstable housing, or illicit drug use.
  • People experiencing homelessness and/or who use illicit drugs remain at highest risk for hepatitis A.
  • Providers should suspect hepatitis A in patients with jaundice, elevated transaminases, and compatible symptoms, even without clear risk factors.
  • Providers are encouraged to offer hepatitis A vaccination to all LA County residents. Handwashing with soap and water remains critical for hepatitis A prevention.
Situation
LAC DPH has declared a communitywide outbreak of hepatitis A virus infections. Typically, 30-50 cases are confirmed per year. Since January 2024, however, there have been 167 cases confirmed in LA County residents, including 29 so far in 2025.
People experiencing homelessness or who use illicit drugs (injection and non-injection) are at higher risk for contracting hepatitis A infection due to limited access to sanitation and potential sharing of drug use equipment. These groups remain a priority for hepatitis A vaccination outreach.
However, most 2025 cases have occurred in people without known risk factors such as travel or being unhoused. Given the increase in cases and the changing risk profile, LAC DPH recommends hepatitis A vaccination for any LA County resident who wishes to be protected.
Actions Requested of Providers
  • Suspect hepatitis A in persons with symptoms of acute hepatitis who either have risk factors for infection (such as experiencing homelessness or using illicit drugs) or who do not have a clear alternative diagnosis for acute hepatitis. Signs and symptoms of hepatitis A include abrupt onset of prodromal symptoms (nausea, anorexia, fever, malaise, or abdominal pain) and jaundice or elevated serum aminotransferase levels. (Note: Up to 30% of adults with acute hepatitis A will not develop jaundice.)
  • Order anti-HAV IgM in patients with suspected hepatitis A. Please instruct the laboratory to hold and send all positive anti-HAV IgM specimens to the LAC DPH Public Health Laboratory for additional testing.
  • Do not discharge patients to the street or shelters if diagnosed with hepatitis A until at least one week after the onset of jaundice. If the patient does not have jaundice, they should not be discharged until 14 days after symptom onset. If the hospital or clinic case manager is unable to find a safe place for discharge of otherwise medically stable patients, please call LAC DPH for assistance: 213-240-7941 during business hours.
  • Offer hepatitis A vaccine to any LA County resident who needs protection from infection. For more information about the vaccine schedule and eligibility, see ph.lacounty.gov/hepatitisAVaccine. See Vaccine Resources below regarding vaccine coverage and availability.
  • Report all patients with acute hepatitis A. See Reporting below.
Clinical laboratories: Please hold and send all anti-HAV IgM positive specimens to the LA County Public Health Laboratory for confirmation of infection by polymerase chain reaction testing.
Vaccine Resources
Hepatitis A vaccine is widely available at primary care provider offices, pharmacies, and participating community sites serving uninsured people. It is also available at no cost at LAC DPH clinics. For clinic hours and locations, refer to the Nurse Clinic information (available in English and Spanish).
Most private health insurance plans should cover hepatitis A vaccine at no cost to beneficiaries.
Medi-Cal: Hepatitis A vaccine is covered for patients enrolled in both fee-for-service and managed care plans. Administration is covered when provided at the patient’s established provider’s office or by an in-network pharmacy. No prior authorization is required. Patients—or those assisting them—can call the plan’s member services number listed on the back of their Medi-Cal Benefits Identification Card for pharmacy service information. Prior to referring a patient to an in-network pharmacy, please confirm vaccine availability directly with the pharmacy.
AIDS Drug Assistance Program (ADAP): Hepatitis vaccine is included on the ADAP formulary.
For questions regarding hepatitis A vaccine and/or supply related to this outbreak, contact the LAC DPH Vaccine Preventable Disease Control Program at 213-351-7800.
Reporting
Immediate Reporting
People experiencing homelessness with symptoms or signs consistent with hepatitis A infection and a positive anti-HAV IgM result should be immediately reported by phone. Report PEH while they are still at the facility.
Food handlers with confirmed hepatitis A infection should be immediately reported by phone.
Los Angeles County DPH Acute Communicable Disease Control:
  • Weekdays 8:30am–5pm: call 213-240-7941.
  • After-hours: call 213-974-1234 and ask for the physician on call.
Long Beach Health and Human Services:
  • Weekdays 8am-5pm: call 562-570-4302.
  • After hours: call the duty officer at 562-500-5537.
Pasadena Public Health Department:
  • Weekdays 8am-5pm: call 626-744-6089.  
  • After hours: call 626-744-6043.
Routine Reporting
Patients with hepatitis A and stable housing must be reported within 1 working day of receiving the positive anti-HAV IgM result.
Los Angeles County DPH Acute Communicable Disease Control:
  • Fax a CMR to 888-397-3778 or 213-482-5508 or send via secure email to ACDC-MorbidityUnit@ph.lacounty.gov, or
  • Call 888-397-3993 weekdays 8:30am–5:00pm 
  • For consultation call 213-240-7941.
Long Beach Health and Human Services:
Pasadena Public Health Department:
Additional Resources
LAC DPH
Centers for Disease Control and Prevention
California Department of Public Health
This communication was sent by Dr. Sharon Balter, Director of Acute Communicable Disease Control Program, Los Angeles County Department of Public Health.
To view a printable PDF of this communication and other LAHAN communications, please visit publichealth.lacounty.gov/lahan.
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