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The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.
Section 3. Summaries of Infectious Diseases
Hepatitis A
Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
Recommendations for Immunoprophylaxis
CLINICAL MANIFESTATIONS: Hepatitis A virus (HAV) infection characteristically is an acute, self-limited illness associated with fever, malaise, jaundice, anorexia, and nausea. Symptomatic hepatitis A infection occurs in approximately 30% of infected children younger than 6 years of age; few of these children will have jaundice. Among older children and adults, infection usually is symptomatic and typically lasts several weeks, with jaundice occurring in approximately 70%. Prolonged or relapsing disease lasting as long as 6 months can occur. Fulminant hepatitis is rare but is more common in people with underlying liver disease. Chronic infection does not occur.
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ETIOLOGY: Hepatitis A virus is an RNA virus classified as a member of the picornavirus group.
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EPIDEMIOLOGY: The most common mode of transmission is person-to-person, resulting from fecal contamination and oral ingestion (ie, the fecal-oral route). Age at infection varies with socioeconomic status and associated living conditions. In developing countries, where infection is endemic, most people are infected during the first decade of life. In the United States, hepatitis A is one of the most commonly reported vaccine-preventable diseases; in 2001, approximately 10 600 clinical cases were reported to the Centers for Disease Control and Prevention (CDC). The highest rates occurred among children 5 to 14 years of age, and the lowest rates occurred among adults older than 40 years of age. During the past several decades, reported cases of hepatitis A infection have had an unequal geographic distribution, with the highest rates of disease occurring in a limited number of states and communities. Although yearly rates in these areas may fluctuate, they consistently remain above the US national average. Continued surveillance
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