Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Hepatitis A virus (HAV) is a highly contagious viral illness that can lead to serious morbidity and occasional mortality. Although the overall incidence of HAV has been declining since the introduction of the HAV vaccine, there have been an increasing number of outbreaks within the United States and elsewhere between 2016 and 2017. These outbreaks have had far reaching consequences, with a large number of patients requiring hospitalization and several deaths. Accordingly, HAV is proving to present a renewed public health challenge. Through the use of the “Identify-Isolate-Inform” Tool as adapted for HAV, emergency physicians can become more familiar with the identification and management of patients presenting to the Emergency Department with exposure, infection, or risk of contracting disease. HAV typically presents with a prodrome of fever, nausea/vomiting, and abdominal pain followed by jaundice. Healthcare providers should maintain strict standard precautions for all patients suspected of having HAV infection as well as contact precautions in special cases. Hand hygiene with soap and water should be emphasized and affected patients should be counseled to avoid food preparation and close contact with vulnerable populations. Additionally, Emergency Department providers should offer post-exposure prophylaxis to exposed contacts and encourage vaccination as well as other preventive measures for at-risk individuals. Emergency department personnel should inform local public health departments of any suspected case.