An outbreak of hepatitis A has spread from Southern California to states across the country, killing dozens of people and potentially sickening thousands. Michigan has been hardest-hit in terms of deaths, with 22.  The outbreak there began in August 2016 and, after a dropoff during the winter, continued to climb last year, according to the Michigan Department of Health and Human Services. As of January 4, there have been 658 cases in Southeast Michigan. Fighting the outbreak was challenging in many jurisdictions due to a national shortage of the vaccine for hepatitis A.

“We have a limited supply of vaccine,” Michigan Department of Health and Human Services spokeswoman Angela Minicuci said in November, “so we are prioritizing delivery to high-risk populations.” The outbreak can be traced to transient camps and illicit drug users in San Diego, officials say. Now, California is in the middle of the biggest person-to-person outbreak of hepatitis A since the vaccine first became available in the mid-’90s, according to the California Department of Public Health. READ MORE