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. 2025 Feb 20;74(5):66-68.
doi: 10.15585/mmwr.mm7405a3.

Notes from the Field: Genomic and Wastewater Surveillance Data to Guide a Hepatitis A Outbreak Response - Los Angeles County, March 2024-June 2024

Jordan B Braunfeld, Bonnie L Dao, Justin Buendia, Raiza Amiling, Cierra LeBlanc, Mirna P Jewell, Hannah Henry, Giorgio Cosentino, Prabhu Gounder

Notes from the Field: Genomic and Wastewater Surveillance Data to Guide a Hepatitis A Outbreak Response - Los Angeles County, March 2024-June 2024

Jordan B Braunfeld et al. MMWR Morb Mortal Wkly Rep. .
No abstract available

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Conflict of interest statement

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Prabhu Gounder reports attendance at a June 2024 wastewater conference funded by Zymo corporation. Hannah Henry reports support from the California Department of Public Health. No other potential conflicts of interest were disclosed.

Figures

FIGURE
FIGURE
Hepatitis A RNA concentrations* measured at two wastewater treatment plants (A) and weekly outbreak-associated (N = 11)† and nonoutbreak-associated hepatitis A case counts (N = 40)§ (B) — Los Angeles County, California, September 2023–June 2024 Abbreviations: ALT = alanine aminotransferase; HAV = hepatitis A virus; IgM = immunoglobulin M; PEH = person experiencing homelessness; PMMoV = pepper mild mottle virus; PWUD = person who uses illicit drugs. * Wastewater RNA concentrations are calculated as a 10-day trimmed average of RNA measurements normalized to PMMoV concentrations. † Outbreak inclusion criteria: positive anti-HAV IgM test result detected after March 1, 2024, in a person with evidence of hepatitis (ALT>200), who lived in Los Angeles County during the incubation or infectious period, and meets at least one of the following additional criteria: 1) experiencing homelessness or using illicit drugs ≤12 months before illness onset, 2) reports close contact with a PEH or PWUD during incubation period, or 3) has received positive test results for the outbreak-associated HAV subgenotype IA strain. § Date of case determined as the earliest date among the following: 1) symptom or jaundice onset date, 2) specimen collection date, 3) reported date, and 4) date elevated enzymes reported.
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References

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