Hepatitis A is most common in children and young adults, but anyone can get hepatitis A

OLYMPIA, Wash. (BUSINESS WIRE): No one should have to be told to wash his or her hands and practice good personal hygiene before leaving the bathroom.

It’s just common sense. But according to the state Department of Health, inattention to such practices among many Washington residents contributes to the spread of hepatitis A, a serious disease of the liver.

Careful attention to cleanliness can help prevent the spread of hepatitis A and other illnesses” said State Epidemiologist Paul Stehr-Green.

In the past two weeks, there has been one hepatitis A alert in Spokane and a second in Seattle. An estimated 13,000 to 20,000 people were possibly exposed at restaurants and day care centers in Spokane in early January. Spokane County is experiencing a hepatitis A outbreak with 69 cases reported since the beginning of January compared to 189 cases in all of 1997. In King County, several hundred Seattle residents may have been exposed to hepatitis A on Jan. 13 and 15 at a Seattle bakery.

The number of hepatitis A cases reported in Washington tends to be cyclical. In 1997, the Department is reporting 800 cases of hepatitis A statewide. (A final number has not yet been tabulated.) Since 1980, the state has seen a low of 500 cases in a year to a high of 3,000 cases in one year.

Most hepatitis A infections are the result of eating or drinking something contaminated by the feces of an infected person. More clearly, individuals become ill with hepatitis A after eating uncooked food prepared by an infected person with poor personal hygiene, especially improper hand washing after using the bathroom or changing a baby’s diaper.

“It can’t be said often enough: Always wash your hands with soap and warm water after using the bathroom, after changing diapers, and before handling food or beverages,” Stehr-Green said.

Hepatitis A is most common in children and young adults, but anyone can get hepatitis A.

Identification and reporting of hepatitis A cases is critical to preventing the spread of the disease,” Stehr-Green said. “If you or your family has been in contact with an infected person, have eaten at a restaurant where a known infection has occurred, or if you think symptoms indicate hepatitis A, contact your doctor or local health department.”

Hepatitis A, a liver disease, causes sudden illness, with symptoms developing over a few days. These can include a lack of energy, diarrhea, fever, nausea, abdominal discomfort and jaundice (yellow color to the whites of the eyes or skin and darkening of urine). Young children may have mild symptoms or none at all, but are still contagious. In adults, the infection usually causes severe illness that can last several months.

When prevention efforts fail, a medication called immune globulin can be used to prevent disease in contacts of infected persons. However, chronic shortages of immune globulin have made it difficult to rely on. In recent weeks, local health officials successfully administered immune globulin to more than 5,000 people affected by the Spokane outbreak.

There is also a very effective vaccine available for hepatitis A,” Stehr-Green said. “Although it is most commonly given to people with weakened immune systems and others traveling to high risk areas, it is available for anyone who wants it.

These recent outbreaks prove that you don’t have to be traveling in a third world country to be at risk for hepatitis A.

Hepatitis A Fact Sheet

What is hepatitis A?

Hepatitis A is a liver disease characterized by a lack of energy, diarrhea, fever, nausea, abdominal discomfort and jaundice (yellow color to the whites of the eyes or skin and darkening of urine). Not all symptoms are experienced by infected persons. Many cases in children have no symptoms. In adults, the infection usually causes severe illness that can last several months.

Who gets hepatitis A?

The virus is most common in children and young adults, but anyone can get hepatitis A.

How common is it in Washington?

There were 1,101 cases in Washington in 1996. In 1995, there were 937 reported Washington and 31,582 in the nation. The last major outbreak was in the second half of the 1980’s, peaking in 1989 with 70 cases per 100,000 people. In the past five years, rates have fluctuated from 16 to 20 cases per 100,000 without a clear trend. Hepatitis A has long term cycles with periodic increases in cases.

Where does it come from?

The virus is present in the feces of an infected person two weeks before and up to two weeks after symptoms begin. The virus is most infectious a week before and a week after symptoms appear. However, an infected person with no symptoms can still infect others.

How is a person exposed?

Most infections are the result of eating something contaminated with the feces of an infected person. People often become infected after they eat uncooked food prepared by an infected person with poor personal hygiene, especially improper hand washing after using the bathroom or changing a baby’s diaper. Although it is uncommon in Washington, contaminated water and raw shellfish can also spread the virus.

How soon do symptoms appear?

Symptoms typically appear 30 days after exposure, but can occur between 15 and 50 days.

Is there a vaccine available?

Yes. The hepatitis A vaccine can provide long-term protection against the disease. Consult your doctor about dose and vaccination schedule, which vary depending on age. Immune globulin can also be useful in fighting hepatitis. When given within 14 days of exposure, it can provide short term protection for persons with hepatitis A exposure who have not been vaccinated.

Who needs to be vaccinated against hepatitis A?

  • Persons 2 years of age and older traveling or working in countries with high rates of hepatitis (Central and South Americas, the Middle East, the Caribbean, Mexico, Asia excluding Japan, Africa, and southern or eastern Europe)
  • Persons who live in communities with high rates of hepatitis A.
  • Persons who have oral-anal sexual contact.
  • Persons who use street drugs.
  • Persons with chronic liver disease.

How can I protect my family?

Pay careful attention to cleanliness. Always wash your hands with soap and water after using the bathroom, after changing diapers, and before handling food or beverages. Do not prepare food for others if you have diarrhea. Don’t drink contaminated water. If you eat raw molluscan shellfish, purchase them from reputable commercial sources or harvest them from an approved beach.

What should I do if I suspect someone I know has hepatitis A?

Identification and reporting of hepatitis A cases is critical to prevent further spread of the disease. If you or your family has been in contact with an infected person, or if you think symptoms indicate hepatitis A, contact your doctor or local health department.

What are health departments doing to control the spread of the virus?

Control of hepatitis A is possible through proper hand washing, immunization with the hepatitis A vaccine, the administration of immune globulin to people who have been exposed to the virus and by providing safe drinking water. The state Department of Health and local health departments help the food service industry, child care providers, and the public to understand the importance of proper personal hygiene. When a food handler becomes infected, health departments take the appropriate steps to control further spread of the disease.

Where can I get more information?

For more information call communicable disease epidemiology 206/361-2914, the hepatitis B program 360/664-3642 or the food program 360/586-1249.

Compiled by epidemiologists at the Washington State Department of Health. 8/97

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