Evolving Characteristics of Decedents With Hepatitis A Listed as a Cause of Death, United States, 2011-2021

J Viral Hepat. 2024 Dec;31(12):783-794. doi: 10.1111/jvh.14002. Epub 2024 Sep 3.

Abstract

Hepatitis A is a vaccine-preventable disease that typically causes mild illness. Hepatitis A outbreaks associated with person-to-person transmission have been widespread in the United States since 2016. We used public-use US Multiple Cause of Death data to compare characteristics and listed comorbidities among decedents with hepatitis A-listed deaths during non-outbreak (2011-2015) and outbreak (2017-2021) periods and assessed the median age at death among decedents with and without hepatitis A-listed deaths during the outbreak period. From the non-outbreak period to the outbreak period, hepatitis A-listed deaths more than doubled (from 369 to 801), while the hepatitis A-listed age-adjusted mortality rate increased 150% (p < 0.001). When compared with the non-outbreak period, hepatitis A-listed decedents during the outbreak period were more frequently male, aged 18-49 years, non-Hispanic White, died in an inpatient setting, and had hepatitis A listed as their underlying cause of death. The median age at death for hepatitis A-listed decedents was significantly younger during the outbreak period overall and among females (62 and 66 years, respectively) compared with the non-outbreak period (64 and 72 years, respectively, p < 0.001). During the outbreak period, median age at death for hepatitis A-listed decedents was 14 years younger than decedents without hepatitis A listed. Compared with the general US population, decedents with hepatitis A listed on the death certificate died at younger ages during 2017-2021. Efforts are needed to improve hepatitis A vaccination coverage among adults recommended for hepatitis A vaccination to prevent additional premature hepatitis A deaths.

Keywords: cause of death; hepatitis A virus; infectious disease outbreak; mortality; vaccine‐preventable disease.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cause of Death*
  • Child
  • Child, Preschool
  • Disease Outbreaks* / statistics & numerical data
  • Female
  • Hepatitis A* / epidemiology
  • Hepatitis A* / mortality
  • Hepatitis A* / prevention & control
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • United States / epidemiology
  • Young Adult