At a glance
Numbers and rates* of reported cases† of hepatitis A, by demographic characteristics — United States, 2018–2022
Characteristics | 2018 No. | 2018 Rate* | 2019 No. | 2019 Rate* | 2020 No. | 2020 Rate* | 2021 No. | 2021 Rate* | 2022 No. | 2022 Rate* |
---|---|---|---|---|---|---|---|---|---|---|
Total§ | 12,474 | 3.8 | 18,846 | 5.7 | 9,952 | 3.0 | 5,728 | 1.7 | 2,265 | 0.7 |
Age (years) | ||||||||||
0–9 | 54 | 0.1 | 127 | 0.3 | 39 | 0.1 | 62 | 0.2 | 23 | 0.1 |
10–19 | 231 | 0.6 | 231 | 0.6 | 90 | 0.2 | 67 | 0.2 | 56 | 0.1 |
20–29 | 2,763 | 6.1 | 3,582 | 7.9 | 1,476 | 3.3 | 757 | 1.7 | 330 | 0.7 |
30–39 | 4,268 | 9.8 | 6,400 | 14.5 | 3,381 | 7.6 | 1,749 | 3.9 | 687 | 1.5 |
40–49 | 2,658 | 6.6 | 4,177 | 10.4 | 2,389 | 5.9 | 1,391 | 3.4 | 420 | 1.0 |
50–59 | 1,509 | 3.5 | 2,635 | 6.2 | 1,497 | 3.6 | 964 | 2.3 | 346 | 0.8 |
≥60 | 987 | 1.4 | 1,691 | 2.3 | 1,077 | 1.4 | 736 | 1.0 | 403 | 0.5 |
Sex | ||||||||||
Male | 7,497 | 4.7 | 11,824 | 7.3 | 6,141 | 3.8 | 3,594 | 2.2 | 1,472 | 0.9 |
Female | 4,952 | 3.0 | 6,997 | 4.2 | 3,802 | 2.3 | 2,126 | 1.3 | 790 | 0.5 |
Race/ethnicity | ||||||||||
American Indian/Alaska Native, non-Hispanic | 15 | 0.5 | 60 | 2.2 | 56 | 2.0 | 27 | 1.1 | 25 | 1.0 |
Asian/Pacific Islander, non-Hispanic | 104 | 0.5 | 139 | 0.7 | 92 | 0.4 | 87 | 0.4 | 98 | 0.5 |
Black, non-Hispanic | 508 | 1.2 | 1,072 | 2.5 | 693 | 1.6 | 585 | 1.4 | 340 | 0.8 |
White, non-Hispanic | 8,670 | 4.3 | 13,709 | 6.8 | 7,780 | 3.9 | 4,044 | 2.1 | 1,245 | 0.6 |
Hispanic | 413 | 0.7 | 916 | 1.5 | 386 | 0.6 | 411 | 0.7 | 388 | 0.6 |
Other | 555 | n/a | 617 | n/a | 216 | n/a | 138 | n/a | 53 | n/a |
Urbanicity¶ | ||||||||||
Urban | 7,657 | 2.7 | 14,637 | 5.2 | 7,972 | 2.8 | 4,421 | 1.5 | 1,876 | 0.7 |
Rural | 3,153 | 6.8 | 3,372 | 7.3 | 1,853 | 4.0 | 1,280 | 2.8 | 387 | 0.8 |
HHS region** | ||||||||||
Region 1: Boston | 410 | 2.8 | 593 | 4.0 | 240 | 1.6 | 94 | 0.6 | 104 | 0.7 |
Region 2: New York | 235 | 0.8 | 1,001 | 3.5 | 412 | 1.5 | 318 | 1.1 | 125 | 0.4 |
Region 3: Philadelphia | 2,498 | 8.1 | 1,611 | 5.2 | 836 | 2.7 | 542 | 1.7 | 300 | 1.0 |
Region 4: Atlanta | 5,030 | 7.6 | 8,900 | 13.3 | 4,959 | 7.3 | 2,648 | 3.9 | 889 | 1.3 |
Region 5: Chicago | 3,074 | 5.9 | 3,562 | 6.8 | 671 | 1.3 | 293 | 0.6 | 147 | 0.3 |
Region 6: Dallas | 407 | 1.0 | 1,166 | 2.7 | 1,430 | 3.3 | 1,132 | 2.6 | 195 | 0.4 |
Region 7: Kansas City | 273 | 1.9 | 393 | 2.8 | 679 | 4.8 | 502 | 3.5 | 206 | 1.4 |
Region 8: Denver | 172 | 1.4 | 392 | 3.2 | 116 | 0.9 | 31 | 0.2 | 47 | 0.4 |
Region 9: San Francisco | 311 | 0.6 | 943 | 1.8 | 276 | 0.5 | 127 | 0.2 | 194 | 0.4 |
Region 10: Seattle | 64 | 0.5 | 285 | 2.0 | 333 | 2.3 | 41 | 0.3 | 58 | 0.4 |
Source: CDC, National Notifiable Diseases Surveillance System.
* Rates per 100,000 population. Beginning in 2021, single-race population estimates are used for rate calculations. For prior years, bridged-race population estimates are used. When comparing the 2021 and 2022 rates by race/ethnicity to prior years, differences may be due to the change in the denominator and should be interpreted with caution (see Technical Notes).
† Reported confirmed cases. For the case definition, see Acute Hepatitis A.
§ Numbers reported in each category may not add up to the total number of reported cases in a year due to cases with missing data.
¶ Urbanicity was categorized according to the 2013 National Center for Health Statistics (NCHS) urban-rural classification scheme for counties and county-equivalent entities. Large central metro, large fringe metro, medium metro, and small metro counties were grouped as urban. Micropolitan and noncore counties were grouped as rural.
** US Department of Health and Human Services regions were categorized according to the grouping of states and US territories assigned under each of the 10 Health and Human Services regional offices. For the purposes of this report, regions with US territories (Region 2 and Region 9) contain data from states only.
n/a: Not applicable. Rate cannot be calculated due to lack of corresponding denominator.
Summary
This table summarizes the epidemiology of hepatitis A in the United States during recent years. A continued decrease in the reported rates of hepatitis A in 2022 follows a period of several years of increasing rates that peaked in 2019 due to widespread and prolonged hepatitis A outbreaks associated with person-to-person transmission, primarily occurring among persons who use drugs and those experiencing homelessness1.
After the peak incidence in 2019 followed by a decline in 2020, the rates among most age, sex, and race and ethnicity categories continued to decrease during 2021 and 2022. In 2022, rates of reported cases of hepatitis A were highest among persons aged 30–49 years, males, and non-Hispanic American Indian/Alaska Native persons.
Using urbanicity categories defined by the National Center for Health Statistics, the rates of hepatitis A in 2022 were higher among rural compared to urban settings. In 2022, rates were highest in US Department of Health and Human Services (HHS) Region 7 (Kansas, Nebraska, Iowa, and Missouri) and lowest in HHS Region 5 (Minnesota, Wisconsin, Illinois, Indiana, Michigan, and Ohio). Among all hepatitis A cases reported during 2022, 49% occurred among persons aged 30–49 years; 58% occurred among non-Hispanic White persons; 83% occurred in urban areas; and 39% occurred in HHS Region 4.
- Centers for Disease Control and Prevention (CDC). Person-to-person outbreaks of hepatitis A across the United States. Atlanta, GA: US Department of Health and Human Services, CDC 2022.