Authors

  1. Ridpath, Alison MD, MPH
  2. Reddy, Vasudha MPH
  3. Layton, Marcelle MD
  4. Misener, Mark MD, MPH
  5. Scaccia, Allison RN
  6. Starr, David MIA
  7. Stavinsky, Faina MS
  8. Varma, Jay K. MD
  9. Waechter, HaeNa MPH
  10. Zucker, Jane R. MD, MSc
  11. Balter, Sharon MD, MFA

Abstract

During 2013, the New York City Department of Health and Mental Hygiene (DOHMH) received reports of 6 hepatitis A cases among food handlers. We describe our decision-making process for public notification, type of postexposure prophylaxis (PEP) offered, and lessons learned. For 3 cases, public notification was issued and DOHMH offered only hepatitis A vaccine as PEP. Subsequent outbreaks resulted from 1 case for which no public notification was issued or PEP offered, and 1 for which public notification was issued and PEP was offered too late. DOHMH continues to use environmental assessments to guide public notification decisions and offer only hepatitis A vaccine as PEP after public notification but recognizes the need to evaluate each situation individually. The PEP strategy employed by DOHMH should be considered because hepatitis A vaccine is immunogenic in all age groups, can be obtained by local jurisdictions more quickly, and is logistically easier to administer in mass clinics than immunoglobulin.