Numbers and rates* of reported cases of hepatitis A virus infection, by demographic characteristics — United States 2016-2020

Numbers and rates* of reported cases† of hepatitis A virus infection, by demographic characteristics — United States 2016-2020
Table 2.2.
Characteristics 2016 No. 2016 Rate* 2017 No. 2017 Rate* 2018 No. 2018 Rate* 2019 No. 2019 Rate* 2020 No. 2020 Rate*
Total§ 2,007 0.6 3,366 1.0 12,474 3.8 18,846 5.7 9,952 3.0
Age (years)
0-9 47 0.1 40 0.1 54 0.1 127 0.3 39 0.1
10-19 131 0.3 86 0.2 231 0.6 231 0.6 90 0.2
20-29 392 0.9 659 1.4 2,763 6.1 3,582 7.9 1,476 3.3
30-39 391 0.9 893 2.1 4,268 9.8 6,400 14.5 3,381 7.6
40-49 333 0.8 621 1.5 2,658 6.6 4,177 10.4 2,381 5.9
50-59 297 0.7 554 1.3 1,509 3.5 2,635 6.2 1,497 3.6
≥60 409 0.6 509 0.7 987 1.4 1,691 2.3 1,077 1.4
Sex
Male 1,107 0.7 2,209 1.4 7,497 4.7 11,824 7.3 6,141 3.8
Female 897 0.5 1,149 0.7 4,952 3.0 6,997 4.2 3,802 2.3
Race/ethnicity
American Indian/Alaska Native 3 0.1 13 0.5 15 0.5 60 2.2 56 2.0
Asian/Pacific Islander 299 1.5 124 0.6 104 0.5 139 0.7 92 0.4
Black, non-Hispanic 137 0.3 303 0.7 508 1.2 1,072 2.5 693 1.6
White, non-Hispanic 865 0.4 1,979 1.0 8,670 4.3 13,709 6.8 7,780 3.9
Hispanic 293 0.5 471 0.8 413 0.7 916 1.5 386 0.6
Urbanicity
Urban 1,769 0.6 3,055 1.1 7,657 2.7 14,637 5.2 7,972 2.8
Rural 182 0.4 180 0.4 3,153 6.8 3,372 7.3 1,853 4.0
HHS Region**
Region 1: Boston 105 0.7 91 0.6 410 2.8 593 4.0 240 1.6
Region 2: New York 173 0.6 289 1.0 235 0.8 1,001 3.5 412 1.5
Region 3: Philadelphia 309 1.0 159 0.5 2,498 8.1 1,611 5.2 836 2.7
Region 4: Atlanta 269 0.4 438 0.7 5,030 7.6 8,900 13.3 4,959 7.3
Region 5: Chicago 259 0.5 855 1.6 3,074 5.9 3,562 6.8 671 1.3
Region 6: Dallas 179 0.4 157 0.4 407 1.0 1,166 2.7 1,430 3.3
Region 7: Kansas City 58 0.4 46 0.3 273 1.9 393 2.8 679 4.8
Region 8: Denver 40 0.3 246 2.1 172 1.4 392 3.2 116 0.9
Region 9: San Francisco 560 1.1 1,033 2.0 311 0.6 943 1.8 276 0.5
Region 10: Seattle 55 0.4 52 0.4 64 0.5 285 2.0 333 2.3

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Source: CDC, National Notifiable Diseases Surveillance System.

* Rates per 100,000 population.

† 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 (https://www.cdc.gov/nchs/data_access/urban_rural.htm). 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 (HHS) Regions were categorized according to the grouping of states and US territories assigned under each of the ten Department of 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.

Compared to 2019, rates among all age, sex, and race/ethnicity categories decreased during 2020. In 2020, rates of reported cases of hepatitis A were highest among persons aged 30–49 years, males, and non-Hispanic White persons.

While rates were highest in 2020 in the US Department of Health and Human Services Region 4 (Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee), the rates in Region 6, Region 7, and Region 10 increased in 2020 compared to 2019.

Using urbanicity categories defined by the National Center for Health Statistics, the rates of hepatitis A in 2020 were higher among rural compared to urban settings. Among all hepatitis A cases reported during 2020, 58% occurred among persons aged 30–49 years; 84% occurred among non-Hispanic White persons; 81% occurred in urban areas; and 52% occurred in Health and Human Services Region 4.