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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 characteristically is an acute, self-limited illness associated with fever, malaise, jaundice, anorexia, and nausea. Symptomatic hepatitis A virus (HAV) 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 70% or more. 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 prevaccine era in the United States, hepatitis A was one of the most commonly reported vaccine-preventable diseases, but its incidence has declined in recent years. In 2004, 5683 cases were reported to the Centers for Disease Control and Prevention (CDC), compared with an average of approximately 26 000 cases per year during the preimmunization era. These declining rates have been accompanied by a shift in age-specific rates. Historically, 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. However, in recent years the highest rates have occurred among young adults, and rates among children 5 to 14 years . . . [Go to Full Text]

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This topic has been referenced by these articles:

• 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]  
• Moss, M. H. (2004). RISK OF ANAPHYLAXIS AFTER VACCINATION OF CHILDREN AND ADOLESCENTS. Pediatrics 114: 524-524 [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]  
• Stein, M. T., Tipnis, N. A., Schultz, P. (2004). Fatigue, Decreased Interest in Play, Motor Delay, and Elevated Liver-Function Tests in a 4-Year-Old Boy. Pediatrics 114: 1437-1441 [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]  
• Chen, O. M., Kaplan, M. S. (2004). EFFECT OF CONJUGATE PNEUMOCOCCAL VACCINE FOLLOWED BY POLYSACCHARIDE PNEUMOCOCCAL VACCINE ON RECURRENT ACUTE OTITIS MEDIA: A RANDOMIZED STUDY. Pediatrics 114: 553-554 [Full Version]  
• American Academy of Pediatrics, (2004). AAP Publications Retired, January 2004. Pediatrics 114: 506-506 [Full Version]  

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