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Appendices

The first 300 words of the full text of this section appear below.

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. Signs and symptoms typically last less than 2 months, although 10% to 15% of symptomatic people have prolonged or relapsing disease lasting as long as 6 months. Fulminant hepatitis is rare but is more common in people with underlying liver disease. Chronic infection does not occur.


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ETIOLOGY

HAV 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). In developing countries, where infection is endemic, most people are infected during the first decade of life. In the United States, hepatitis A was one of the most frequently reported vaccine-preventable diseases in the prevaccine era, but incidence of disease attributable to HAV has declined since hepatitis A vaccine was licensed in 1995. In 2007, 2979 cases were reported to the Centers for Disease Control and Prevention (CDC), compared with 22 000 to 36 000 hepatitis A cases reported annually from 1980 through 1995. 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. Beginning in the late 1990s, national . . . [Go to Full Text]


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This topic has been referenced by these articles:

  • Armstrong, G. L., Billah, K., Rein, D. B., Hicks, K. A., Wirth, K. E., Bell, B. P. (2007). The Economics of Routine Childhood Hepatitis A Immunization in the United States: The Impact of Herd Immunity. Pediatrics 119: e22-e29 [Abstract] [Full Version]  
  • Selda, H. B., Ozden, A., Tanzer, F., Kisa, U., Buyukkayhan, D., Misirrlioglou, E. D., Kisa, O. (2008). TRANSMISSION OF HELICOBACTER PYLORI INFECTION IN MOTHER-INFANT PAIRS. Pediatrics 121: S110-S111 [Abstract]  
  • Kyrka, A., Tragiannidis, A., Pantelaki, K., Tzivaras, A., Athanasiadou, F., Konstantopoulos, A., Papaevangelou, V. (2008). SEROEPIDEMIOLOGY OF HEPATITIS A IN GREEK CHILDREN. Pediatrics 121: S108-S109 [Abstract]  
  • Nolan, T., Bernstein, H., Blatter, M. M., Bromberg, K., Guerra, F., Kennedy, W., Pichichero, M., Senders, S. D., Trofa, A., Collard, A., Sullivan, D. C., Descamps, D. (2006). Immunogenicity and Safety of an Inactivated Hepatitis A Vaccine Administered Concomitantly With Diphtheria-Tetanus-Acellular Pertussis and Haemophilus influenzae Type B Vaccines to Children Less Than 2 Years of Age. Pediatrics 118: e602-e609 [Abstract] [Full Version]  
  • Committee on Infectious Diseases, (2007). Hepatitis A Vaccine Recommendations. Pediatrics 120: 189-199 [Abstract] [Full Version]  
  • Brenneman, G., Rhoades, E., Chilton, L. (2006). Forty Years in Partnership: The American Academy of Pediatrics and the Indian Health Service. Pediatrics 118: e1257-e1263 [Abstract] [Full Version]  
  • Rein, D. B., Hicks, K. A., Wirth, K. E., Billah, K., Finelli, L., Fiore, A. E., Hoerger, T. J., Bell, B. P., Armstrong, G. L. (2007). Cost-Effectiveness of Routine Childhood Vaccination for Hepatitis A in the United States. Pediatrics 119: e12-e21 [Abstract] [Full Version]