Hepatitis A

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	Section 1 Section 2 Section 3 Section 4 Section 5 Appendices

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

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CLINICAL MANIFESTATIONS: Hepatitis A virus (HAV) infectioncharacteristically is an acute, self-limited illness associatedwith fever, malaise, jaundice, anorexia, and nausea. Symptomatichepatitis A infection occurs in approximately 30% of infectedchildren younger than 6 years of age; few of these childrenwill have jaundice. Among older children and adults, infectionusually is symptomatic and typically lasts several weeks, withjaundice occurring in approximately 70%. Prolonged or relapsingdisease lasting as long as 6 months can occur. Fulminant hepatitisis 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 amember 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, thefecal-oral route). Age at infection varies with socioeconomicstatus and associated living conditions. In developing countries,where infection is endemic, most people are infected duringthe first decade of life. In the United States, hepatitis Ais one of the most commonly reported vaccine-preventable diseases;in 2001, approximately 10 600 clinical cases were reported tothe Centers for Disease Control and Prevention (CDC). The highestrates occurred among children 5 to 14 years of age, and thelowest rates occurred among adults older than 40 years of age.During the past several decades, reported cases of hepatitisA infection have had an unequal geographic distribution, withthe highest rates of disease occurring in a limited number ofstates and communities. Although yearly rates in these areasmay fluctuate, they consistently remain above the US nationalaverage. Continued surveillance . . . [Go to Full Text]

Related text in Red Book:

Summary of Major Changes in the 2003 Red Book: Red Book 2003: xxv. [Extract] [Full Version]
Unknown or Uncertain Immunization Status: Red Book 2003: 33-34. [Extract] [Full Version]
Active Immunization of People Who Recently Received Immune Globulin: Red Book 2003: 35-36. [Extract] [Full Version]
Immune Globulin: Red Book 2003: 54-56. [Extract] [Full Version]
International Travel: Red Book 2003: 93-98. [Extract] [Full Version]
Immunocompromised Children: Red Book 2003: 69-81. [Extract] [Full Version]
Children With Chronic Diseases: Red Book 2003: 82. [Extract] [Full Version]
American Indian/Alaska Native Children: Red Book 2003: 84-85. [Extract] [Full Version]
Medical Evaluation of Internationally Adopted Children for Infectious Diseases: Red Book 2003: 173-180. [Extract] [Full Version]
Blood Safety: Reducing the Risk of Transfusion-Transmitted Infections: Red Book 2003: 106-116. [Extract] [Full Version]
Children in Out-of-Home Child Care: Red Book 2003: 123-137. [Extract] [Full Version]
School Health: Red Book 2003: 137-146. [Extract] [Full Version]
Hepatitis and Youth in Corrections Settings: Red Book 2003: 167-173. [Extract] [Full Version]
Hepatitis B: Red Book 2003: 318-336. [Extract] [Full Version]
Human Immunodeficiency Virus Infection: Red Book 2003: 360-382. [Extract] [Full Version]

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Venczel, L. V., Desai, M. M., Vertz, P. D., England, B., Hutin, Y. J. F., Shapiro, C. N., Bell, B. P. (2001). The Role of Child Care in a Community-Wide Outbreak of Hepatitis A. Pediatrics 108: e78-78 [Abstract] [Full Version]
Nachman, S., Gona, P., Dankner, W., Weinberg, A., Yogev, R., Gershon, A., Rathore, M., Read, J. S., Huang, S., Elgie, C., Hudgens, K., Hughes, W. (2005). The Rate of Serious Bacterial Infections Among HIV-Infected Children With Immune Reconstitution Who Have Discontinued Opportunistic Infection Prophylaxis. Pediatrics 115: e488-e494 [Abstract] [Full Version]
Staes, C. J., Schlenker, T. L., Risk, I., Cannon, K. G., Harris, H., Pavia, A. T., Shapiro, C. N., Bell, B. P. (2000). Sources of Infection Among Persons With Acute Hepatitis A and No Identified Risk Factors During a Sustained Community-Wide Outbreak. Pediatrics 106: 54e-54 [Abstract] [Full Version]
Committee on Infectious Diseases, (2006). Recommended Childhood and Adolescent Immunization Schedule--United States, 2006. Pediatrics 117: 239-240 [Full Version]
Committee on Infectious Diseases, (2000). Recommended Childhood Immunization Schedule---United States, January-December 2000. Pediatrics 105: 148-151 [Full Version]
Bardenheier, B., Gonzalez, I. M., Washington, M. L., Bell, B. P., Averhoff, F., Massoudi, M. S., Hyams, I., Simard, E. P., Yusuf, H. (2003). Parental Knowledge, Attitudes, and Practices Associated With Not Receiving Hepatitis A Vaccine in a Demonstration Project in Butte County, California. Pediatrics 112: e269-269 [Abstract] [Full Version]
Aach, R. D., Yomtovian, R. A., Hack, M. (2000). Neonatal and Pediatric Posttransfusion Hepatitis C: A Look Back and a Look Forward. Pediatrics 105: 836-842 [Full Version]
Yim, R., Wald, E. R. (2005). Misinterpretation of Liver-Function Tests and West Nile Virus Infection in Children: In Reply. Pediatrics 115: 1445-1446 [Full Version]
Hochman, J. A. (2005). Misinterpretation of Liver-Function Tests and West Nile Virus Infection in Children. Pediatrics 115: 1445-1445 [Full Version]
Shah, U., Habib, Z. (2000). Liver Failure Attributable to Hepatitis A Virus Infection in a Developing Country. Pediatrics 105: 436-438 [Abstract] [Full Version]
Thatayatikom, A., Liu, A. H. (2003). IDENTIFICATION OF Tapr (AN AIRWAY HYPERREACTIVITY REGULATORY LOCUS) AND THE LINKED Tim GENE FAMILY. Pediatrics 112: 470-470 [Full Version]
Weinberg, M., Hopkins, J., Farrington, L., Gresham, L., Ginsberg, M., Bell, B. P. (2004). Hepatitis A in Hispanic Children Who Live Along the United States-Mexico Border: The Role of International Travel and Food-Borne Exposures. Pediatrics 114: e68-e73 [Abstract] [Full Version]
Armstrong, G. L., Bell, B. P. (2002). Hepatitis A Virus Infections in the United States: Model-Based Estimates and Implications for Childhood Immunization. Pediatrics 109: 839-845 [Abstract] [Full Version]
Amon, J. J., Darling, N., Fiore, A. E., Bell, B. P., Barker, L. E. (2006). Factors Associated With Hepatitis A Vaccination Among Children 24 to 35 Months of Age: United States, 2003. Pediatrics 117: 30-33 [Abstract] [Full Version]
Brouwer, C. N. M., Maille, A. R., Rovers, M. M., Veenhoven, R. H., Grobbee, D. E., Sanders, E. A. M., Schilder, A. G. M. (2005). Effect of Pneumococcal Vaccination on Quality of Life in Children With Recurrent Acute Otitis Media: A Randomized, Controlled Trial. Pediatrics 115: 273-279 [Abstract] [Full Version]
American Academy of Pediatrics, (2004). AAP Publications Retired, January 2004. Pediatrics 114: 506-506 [Full Version]

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