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Increase in hepatitis A infections in parts of the United States. Compared with 2013 to 2015, nine states and Washington, DC, had about a 500% increase in hepatitis A infections between 2016 and 2018, whereas 18 states had fewer cases during the same period. According to the May 10 Morbidity and Mortality Weekly Report, the increase in hepatitis A infections especially occurred among drug users, homeless people, and men who have sex with men. People who eat contaminated foods imported from countries with high rates of hepatitis A transmission are also vulnerable to infection. It's vital to increase the hepatitis A vaccination rate in at-risk people to stop the current hepatitis A outbreaks. Previous outbreaks occurred mostly in children, but childhood hepatitis A vaccination now protects against the disease. The United States has no universal recommendation for hepatitis A vaccination in adults.