Numbers and rates* of reported cases of Hepatitis A virus infection, by demographic characteristics — United States, 2017–2021

Numbers and rates* of reported cases of Hepatitis A virus infection, by demographic characteristics — United States 20172021
Table 2.2.
Characteristics 2017 No. 2017 Rate* 2018 No. 2018 Rate* 2019 No. 2019 Rate* 2020 No. 2020 Rate* 2021 No. 2021 Rate*
Total§ 3,366 1.0 12,474 3.8 18,846 5.7 9,952 3.0 5,728 1.7
Age (Years)
0–9 40 0.1 54 0.1 127 0.3 39 0.1 62 0.2
10–19 86 0.2 231 0.6 231 0.6 90 0.2 67 0.2
20–29 659 1.4 2,763 6.1 3,582 7.9 1,476 3.3 757 1.7
30–39 893 2.1 4,268 9.8 6,400 14.5 3,381 7.6 1,749 3.9
40–49 621 1.5 2,658 6.6 4,177 10.4 2,389 5.9 1,391 3.4
50–59 554 1.3 1,509 3.5 2,635 6.2 1,497 3.6 964 2.3
≥60 509 0.7 987 1.4 1,691 2.3 1,077 1.4 736 1.0
Sex
Male 2,209 1.4 7,497 4.7 11,824 7.3 6,141 3.8 3,594 2.2
Female 1,149 0.7 4,952 3.0 6,997 4.2 3,802 2.3 2,126 1.3
Race/Ethnicity
American Indian/Alaska Native, non-Hispanic 13 0.5 15 0.5 60 2.2 56 2.0 27 1.1
Asian/Pacific Islander, non-Hispanic 124 0.6 104 0.5 139 0.7 92 0.4 87 0.4
Black, non-Hispanic 303 0.7 508 1.2 1,072 2.5 693 1.6 585 1.4
White, non-Hispanic 1,979 1.0 8,670 4.3 13,709 6.8 7,780 3.9 4,044 2.1
Hispanic 471 0.8 413 0.7 916 1.5 386 0.6 411 0.7
Urbanicity
Urban 3,055 1.1 7,657 2.7 14,637 5.2 7,972 2.8 4,421 1.5
Rural 180 0.4 3,153 6.8 3,372 7.3 1,853 4.0 1,280 2.8
HHS Region**
Region 1: Boston 91 0.6 410 2.8 593 4.0 240 1.6 94 0.6
Region 2: New York 289 1.0 235 0.8 1,001 3.5 412 1.5 318 1.1
Region 3: Philadelphia 159 0.5 2,498 8.1 1,611 5.2 836 2.7 542 1.7
Region 4: Atlanta 438 0.7 5,030 7.6 8,900 13.3 4,959 7.3 2,648 3.9
Region 5: Chicago 855 1.6 3,074 5.9 3,562 6.8 671 1.3 293 0.6
Region 6: Dallas 157 0.4 407 1.0 1,166 2.7 1,430 3.3 1,132 2.6
Region 7: Kansas City 46 0.3 273 1.9 393 2.8 679 4.8 502 3.5
Region 8: Denver 246 2.1 172 1.4 392 3.2 116 0.9 31 0.2
Region 9: San Francisco 1,033 2.0 311 0.6 943 1.8 276 0.5 127 0.2
Region 10: Seattle 52 0.4 64 0.5 285 2.0 333 2.3 41 0.3

 

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 rates by race/ethnicity to prior years, difference 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 or, in the case of race/ethnicity, cases categorized as “Other.”
¶ 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.

This table summarizes the epidemiology of hepatitis A in the United States during recent years, highlighting the populations most affected by outbreaks of hepatitis A occurring among persons who use drugs and persons experiencing homelessness.

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. In 2021, rates of reported cases of hepatitis A were highest among persons aged 30–49 years, males, and non-Hispanic White persons.

Using urbanicity categories defined by the National Center for Health Statistics, the rates of hepatitis A in 2021 were higher among rural compared to urban settings. Rates were highest in 2021 in US Department of Health and Human Services Region 4 (Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee) but decreased in all US Department of Health and Human Services regions in 2021 compared to 2020. Among all hepatitis A cases reported during 2021, 55% occurred among persons aged 30–49 years; 76% occurred among non-Hispanic White persons; 78% occurred in urban areas; and 46% occurred in Health and Human Services Region 4.