According to the Chinese news agency reported on October 16, Los Angeles, the United States recently broke out in 22 years the largest human-to-human hepatitis A outbreak. The Chinese Consulate General in Los Angeles issued a consular alert on October 16, reminding Chinese citizens in the consular district to pay attention to the hepatitis A outbreak. The U.S. California Department of Public Health reported that since the end of 2016, California San Diego and other places outbreak of hepatitis A outbreak and has a tendency to spread. As of October 13, California found 581 cases of infection, has led to at least 18 deaths, is the 1995 hepatitis A vaccine since the introduction of the nation’s largest human-to-human hepatitis A outbreak. This is a recent news item. Not coincidentally, Australia has also had a recent hepatitis A outbreak. Since the first case of Hepatitis A was detected in the Australian state of New South Wales (the state capital of Sydney) on July 1, 2017, as of October 3, a total of 27 people infected with Hepatitis A have been detected. Delving deeper into these 27 infections, they found that a significant number were surprisingly spread through same-sex sexual behavior. Of these 27 infected persons, 25 were male and only 2 were female. And 12 of the 25 men admitted to being homosexuals. The two earliest cases were imported cases, both male, both had traveled, one had just been to the UK and France, the other had just been to Hong Kong and Singapore, and both of them had transmitted hepatitis A to other people during their daily life contacts. And at least three of the later infections, at least very clearly, occurred after one of them was infected with hepatitis A and had homosexual sex, and the other soon developed symptoms of hepatitis A. In almost all three cases, there was oral-anal contact. There were also some cases where history taking was unknown (patients were reluctant to provide it). Experts believe that this hepatitis A outbreak temporarily rules out a food factor for a mass epidemic and is primarily related to male homosexuality. Hepatitis A is primarily a gastrointestinal disease, spread through food, and the 1988 Shanghai outbreak was associated with the consumption of arkshells. In fact, this mode of food transmission is more accurately called the “fecal-oral route”. The vast majority of hepatitis A infections are indirectly transmitted fecal-oral, but hepatitis A can definitely be transmitted through direct contact, such as homosexual or even heterosexual “anal licking”. The Australian study confirms this. However, it’s not clear how much of a factor food is in the US pandemic, and let’s not read my article and assume that the US pandemic is predominantly homosexual. After all, sexual transmission of hepatitis A is a very small percentage.