Calif. hep A outbreak could prove costly to providers

Health officials in Los Angeles County last week declared an outbreak of hepatitis A after two local cases were identified.

A total of 10 cases have been reported in the county as of Sept. 19, according to public health officials. San Diego has seen more than 440 confirmed cases and more than 300 hospitalizations in less than a year. In Santa Cruz County, 69 cases have been reported since April, with 33 hospitalizations.

Most of the cases in all three counties reportedly involved people who are either homeless or using illicit drugs— two populations known to have lower rates of insurance coverage and higher rates of emergency department visits and hospitalizations compared to national averages.

UC San Diego Health has been running a hepatitis A vaccination program at its free clinics as well as at one of its emergency rooms. Those efforts over the past three months have provided vaccinations to more than 480 residents and nearly 900 of healthcare workers. The hospital confirmed it has received patients since the beginning of the outbreak, but could not provide a cost estimate. A spokeswoman said that costs related to treating a hepatitis A patient vary depending on their current or underlying condition.

A 2012 study published in the journal Health Outcomes Research in Medicine found hepatitis A patients covered under commercial health insurance plans had “significantly higher” healthcare utilization and expenditures than non-infected patients, with an average cost per patient of $11,479 versus $5,323.

Cases of hepatitis A have declined in the U.S. by 95% since a vaccine was first introduced in 1995, but a number of outbreaks have occurred in recent years, usually stemming from contaminated food.