The New York City Department of Health and Mental Hygiene (NYCDOHMH) reported a significant increase of Hepatitis A infections in men who have sex with men (MSM). The New York State Department of Health (NYSDOH) also found a similar increase among individuals living outside of the city. Since January 1, 2017, there has been a ten-times increase of reported cases within the MSM population living in New York City, which may be linked to outbreaks in 16 European countries.
While Long Island was not specifically mentioned in these alerts, our close proximity to the city and surrounding areas puts us at a high risk. According to the latest data gathered by the NYSDOH, there were 61 cases of Hepatitis A in Nassau and Suffolk Counties from 2013 to 2015, which is higher than any other region outside of NYC.
Hepatitis A is a communicable disease of the liver caused by the Hepatitis A virus (HAV). The virus is usually transmitted when the feces of an infected person gets into the mouth of another person; usually when a person consumes food or water that is contaminated with the feces of an infected person. Even a microscopic amount is enough to cause infection. Transmission can also occur when someone puts their mouth, lips, or tongue on another person’s anus or objects that were near another person’s anus, such as a penis, finger, condom, or sex toy. Once inside the body, the virus attacks the liver and may cause symptoms that can last up to several months, including fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, grey-colored stools, joint pain, and jaundice.
While most people recover completely from Hepatitis A after a couple of months, a few severe cases may be life-threatening. To treat the infection, doctors usually recommend rest and medical monitoring until the infection has passed. Some people may need to be hospitalized.
Fortunately, there is an HAV vaccine that will prevent infection. It is recommended that all gay, bisexual, or other men who have sex with men be vaccinated. Depending on the vaccine, 2 or 3 shots over time may be needed to provide full protection. For those people who are unsure of their vaccination history, the NYSDOH recommends getting one nonetheless; there is no harm in repeating the vaccination. Vaccine costs are covered through the New York State Medicaid program, AIDS Drug Assistance Program, and most private insurances.
If you have had sex, shared drugs, or lived with someone with Hepatitis A within the last two weeks, getting the vaccine or immune globulin can help protect you. The sooner you seek medical attention the better.
For the gay, bisexual, and other men who have sex with men (MSM) that live on Long Island, Long Island Association for AIDS Care, Inc. (LIAAC) has several programs tailored to this population that can make Hepatitis A prevention, diagnosis, and treatment easier:
- Project Safety Net provide referrals for Hepatitis A (HAV) and Hepatitis B (HBV) testing and vaccinations.
- YMSM Alternative Prevention and Care links young men who have sex with men to primary care physicians.
- Prevention Education provide educational workshops; offer free and confidential HIV, Hepatitis C (HCV), and STI testing; as well as create campaigns to spread awareness.
All of these programs also provide the MSM population with free and confidential HIV testing, education, and linkage to care, as people living with HIV are disproportionally affected by viral hepatitis. An HIV infection causes viral hepatitis to progress faster and causes more liver damage to occur than among those who do not have HIV.
For more information about Hepatitis A, please visit the sites below. If you have more questions, your doctor or local health care providers are great tools to help you better understand the disease.
Long Island Association for AIDS Care, Inc.
Free & Confidential Hotline 877-865-4222
New York State Department of Health
Lesbian, Gay, Bisexual and Transgender Health: https://www.health.ny.gov/diseases/aids/consumers/lgbt/
Fact Sheet on Hepatitis A: https://www.health.ny.gov/publications/1859/
Information for Consumers – Hepatitis A: https://www.health.ny.gov/diseases/communicable/hepatitis/hepatitis_a/consumer.htm
Information for Providers – Hepatitis A: https://www.health.ny.gov/diseases/communicable/hepatitis/hepatitis_a/provider.htm
Centers for Disease Control and Prevention (CDC)
Hepatitis Fact Sheet for Gay and Bisexual Men: https://www.cdc.gov/hepatitis/hav/patienteduhav.htm
Hepatitis A Questions and Answers for the Public: https://www.cdc.gov/hepatitis/hav/afaq.htm
Patient Education Resources: https://www.cdc.gov/hepatitis/hav/patienteduhav.htm
Hepatitis A Questions and Answers for Health Professionals: https://www.cdc.gov/hepatitis/hav/havfaq.htm
Vaccine Information Statements: http://www.immunize.org/vis/vis_hepatitis_a.asp
 New York City Department of Health and Mental Hygiene. 2017 DOHMH Alert #34: UPDATE: Increase in Cases of Hepatitis Among Men Who Have Sex With Men https://www1.nyc.gov/assets/doh/downloads/pdf/han/alert/alert34-hepatitis-a-among-men.pdf.
 Latash J, Dorsinville M, Del Rosso P, et al. Notes from the Field: Increase in Reported Hepatitis A Infections Among Men Who Have Sex with Men — New York City, January–August 2017. MMWR Morb Mortal Wkly Rep 2017;66:999–1000. DOI: http://dx.doi.org/10.15585/mmwr.mm6637a7 .
 European Centre for Disease Prevention and Control. Rapid risk assessment: hepatitis A outbreak in the EU/EEA mostly affecting men who have sex with men. Third update, June 28, 2017. Solna, Sweden: European Centre for Disease Prevention and Control; 2017. https://ecdc.europa.eu/en/publications- data/rapid-risk-assessment-hepatitis-outbreak-eueea-mostly-affecting-men-who-have-sex .