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| ==Overview== | | ==Overview== |
| | [[Hepatitis A virus]] was first identified in 1973. It was classified as a separate disease from other types of [[hepatitis]] during World War II. However, its true [[prevalence]] and route of [[transmission]] would only be recognized later. During 1995-1996, the Food and Drug Administration (FDA) approved the inactivated hepatitis A vaccine. Consequently, [[hepatitis A]] became a disease that was not only common but also vaccine-preventable. |
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| ==Historical Perspective== | | == Historical Perspective == |
| ===Prevaccine Era===
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| Hepatitis A epidemiology in the United States has fundamentally changed with licensure of hepatitis A vaccine and implementation of national ACIP recommendations for its use. Before vaccine licensure during 1995-1996, hepatitis A incidence was primarily cyclic, with peaks occurring every 10-15 years. In the United States, during 1980-1995, approximately 22,000-36,000 hepatitis A cases were reported annually to CDC (rate: 9.0-14.5 cases per 100,000 population), but incidence models indicate that the number of infections was substantially higher.<ref name="pmid11986444">{{cite journal |author=Armstrong GL, Bell BP |title=Hepatitis A virus infections in the United States: model-based estimates and implications for childhood immunization |journal=[[Pediatrics]] |volume=109 |issue=5 |pages=839–45 |year=2002 |month=May |pmid=11986444 |doi= |url=http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=11986444 |accessdate=2012-02-28}}</ref><ref>CDC. Hepatitis surveillance. Report no. 61. Atlanta, GA: US Department of Health and Human Services, CDC. 2006</ref> One such analysis estimated an average of 271,000 infections per year during 1980-1999, representing 10.4 times the reported number of cases.<ref name="pmid11986444">{{cite journal |author=Armstrong GL, Bell BP |title=Hepatitis A virus infections in the United States: model-based estimates and implications for childhood immunization |journal=[[Pediatrics]] |volume=109 |issue=5 |pages=839–45 |year=2002 |month=May |pmid=11986444 |doi= |url=http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=11986444 |accessdate=2012-02-28}}</ref> Each year in the United States, an estimated 100 persons died as a result of acute liver failure attributed to hepatitis A.
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| The costs associated with hepatitis A are substantial. Surveillance data indicate that 11%-22% of persons with hepatitis A are hospitalized.<ref>[http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4812a1.htm CDC. Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1999;48(No. RR-12):1-37]</ref> The average duration of work loss for adults who become ill has been estimated at 15.5 days for nonhospitalized patients and 33.2 days for hospitalized patients.<ref name="pmid10655272">{{cite journal |author=Berge JJ, Drennan DP, Jacobs RJ, Jakins A, Meyerhoff AS, Stubblefield W, Weinberg M |title=The cost of hepatitis A infections in American adolescents and adults in 1997 |journal=[[Hepatology (Baltimore, Md.)]] |volume=31 |issue=2 |pages=469–73 |year=2000 |month=February |pmid=10655272 |doi=10.1002/hep.510310229 |url=http://dx.doi.org/10.1002/hep.510310229 |accessdate=2012-02-28}}</ref> Estimates of the annual direct and indirect costs of hepatitis A in the United States have ranged from $300 million to $488.8 million in 1997 dollars.<ref>[http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4812a1.htm CDC. Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1999;48(No. RR-12):1-37]</ref><ref name="pmid10655272">{{cite journal |author=Berge JJ, Drennan DP, Jacobs RJ, Jakins A, Meyerhoff AS, Stubblefield W, Weinberg M |title=The cost of hepatitis A infections in American adolescents and adults in 1997 |journal=[[Hepatology (Baltimore, Md.)]] |volume=31 |issue=2 |pages=469–73 |year=2000 |month=February |pmid=10655272 |doi=10.1002/hep.510310229 |url=http://dx.doi.org/10.1002/hep.510310229 |accessdate=2012-02-28}}</ref> A recent Markov model analysis estimated economic costs of $133.5 million during the lifetime of a single age cohort of children born in 2005, in the absence of vaccination. | | The earliest descriptions of diseases similar to [[Hepatitis A virus]] were reported 5000 years ago in China. Hippocrates also described a disease resembling hepatitis A that he called benign epidemic jaundice <ref name="pmid29712682">{{cite journal| author=Feinstone SM| title=History of the Discovery of Hepatitis A Virus. | journal=Cold Spring Harb Perspect Med | year= 2019 | volume= 9 | issue= 5 | pages= | pmid=29712682 | doi=10.1101/cshperspect.a031740 | pmc=6496330 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29712682 }} </ref>. |
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| ====Sources of Infection====
| | During the 17th century, outbreaks of hepatitis A were reported in military camps. In the US, first outbreak of more than 40,000 cases was reported in 1812 in Norfolk, VA. An estimated 16 million cases of hepatitis A were reported during the world war I and World War II <ref name="pmid29712682">{{cite journal| author=Feinstone SM| title=History of the Discovery of Hepatitis A Virus. | journal=Cold Spring Harb Perspect Med | year= 2019 | volume= 9 | issue= 5 | pages= | pmid=29712682 | doi=10.1101/cshperspect.a031740 | pmc=6496330 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29712682 }} </ref>. |
| In the prevaccine era, the majority of U.S. cases of hepatitis A resulted from person-to-person transmission of HAV during communitywide outbreaks.<ref name="pmid9815207">{{cite journal |author=Bell BP, Shapiro CN, Alter MJ, Moyer LA, Judson FN, Mottram K, Fleenor M, Ryder PL, Margolis HS |title=The diverse patterns of hepatitis A epidemiology in the United States-implications for vaccination strategies |journal=[[The Journal of Infectious Diseases]] |volume=178 |issue=6 |pages=1579–84 |year=1998 |month=December |pmid=9815207 |doi= |url=http://www.jid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=9815207 |accessdate=2012-02-28}}</ref><ref>CDC. Communitywide outbreaks of hepatitis A. Hepatitis surveillance. Report no. 51. Atlanta, GA: US Department of Health and Human Services, CDC; 1987:6-8.</ref> The most frequently reported source of infection (in 12%-26% of cases) was household or sexual contact with a person with hepatitis A.<ref name="pmid1476001">{{cite journal |author=Shapiro CN, Coleman PJ, McQuillan GM, Alter MJ, Margolis HS |title=Epidemiology of hepatitis A: seroepidemiology and risk groups in the USA |journal=[[Vaccine]] |volume=10 Suppl 1 |issue= |pages=S59–62 |year=1992 |pmid=1476001 |doi= |url= |accessdate=2012-02-28}}</ref> Cyclic outbreaks occurred among users of injection and noninjection drugs and among men who have sex with men (MSM),<ref name="pmid12696002">{{cite journal |author=Cotter SM, Sansom S, Long T, Koch E, Kellerman S, Smith F, Averhoff F, Bell BP |title=Outbreak of hepatitis A among men who have sex with men: implications for hepatitis A vaccination strategies |journal=[[The Journal of Infectious Diseases]] |volume=187 |issue=8 |pages=1235–40 |year=2003 |month=April |pmid=12696002 |doi=10.1086/374057 |url=http://www.jid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=12696002 |accessdate=2012-02-28}}</ref><ref name="pmid2929804">{{cite journal |author=Harkess J, Gildon B, Istre GR |title=Outbreaks of hepatitis A among illicit drug users, Oklahoma, 1984-87 |journal=[[American Journal of Public Health]] |volume=79 |issue=4 |pages=463–6 |year=1989 |month=April |pmid=2929804 |pmc=1349976 |doi= |url= |accessdate=2012-02-28}}</ref><ref name="pmid3140269">{{cite journal |author=Schade CP, Komorwska D |title=Continuing outbreak of hepatitis A linked with intravenous drug abuse in Multnomah County |journal=[[Public Health Reports (Washington, D.C. : 1974)]] |volume=103 |issue=5 |pages=452–9 |year=1988 |pmid=3140269 |pmc=1478131 |doi= |url= |accessdate=2012-02-28}}</ref><ref name="pmid10358687">{{cite journal |author=Hutin YJ, Bell BP, Marshall KL, Schaben CP, Dart M, Quinlisk MP, Shapiro CN |title=Identifying target groups for a potential vaccination program during a hepatitis A communitywide outbreak |journal=[[American Journal of Public Health]] |volume=89 |issue=6 |pages=918–21 |year=1999 |month=June |pmid=10358687 |pmc=1508638 |doi= |url= |accessdate=2012-02-28}}</ref><ref name="pmid15620475">{{cite journal |author=Vong S, Fiore AE, Haight DO, Li J, Borgsmiller N, Kuhnert W, Pinero F, Boaz K, Badsgard T, Mancini C, Nainan OV, Wiersma S, Bell BP |title=Vaccination in the county jail as a strategy to reach high risk adults during a community-based hepatitis A outbreak among methamphetamine drug users |journal=[[Vaccine]] |volume=23 |issue=8 |pages=1021–8 |year=2005 |month=January |pmid=15620475 |doi=10.1016/j.vaccine.2004.07.038 |url=http://linkinghub.elsevier.com/retrieve/pii/S0264-410X(04)00622-X |accessdate=2012-02-28}}</ref> and up to 15% of nationally reported cases occurred among persons reporting one or more of these behaviors. Other potential sources of infection (e.g., international travel and recognized foodborne outbreaks) were reported among 3%--6% of cases.<ref name="pmid1476001">{{cite journal |author=Shapiro CN, Coleman PJ, McQuillan GM, Alter MJ, Margolis HS |title=Epidemiology of hepatitis A: seroepidemiology and risk groups in the USA |journal=[[Vaccine]] |volume=10 Suppl 1 |issue= |pages=S59–62 |year=1992 |pmid=1476001 |doi= |url= |accessdate=2012-02-28}}</ref> For approximately 50% of persons with hepatitis A, no source was identified for their infection.
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| ===Vaccine Era===
| | Hepatitis A virus was first identified in 1973. In the US, hepatitis A vaccine was approved by the Food and Drug Administration (FDA) in 1995. |
| With the licensure of inactivated hepatitis A vaccines by the Food and Drug Administration (FDA) during 1995-1996, hepatitis A became a disease that was not only common but also vaccine-preventable. Since 1996, and particularly since ACIP's 1999 recommendations for routine vaccination of children living in areas with consistently elevated hepatitis A rates, national hepatitis A rates have declined sharply.<ref name="pmid16014593">{{cite journal |author=Wasley A, Samandari T, Bell BP |title=Incidence of hepatitis A in the United States in the era of vaccination |journal=[[JAMA : the Journal of the American Medical Association]] |volume=294 |issue=2 |pages=194–201 |year=2005 |month=July |pmid=16014593 |doi=10.1001/jama.294.2.194 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=16014593 |accessdate=2012-02-28}}</ref> The 1999 recommendations called for routine vaccination of children living in states and communities in which the average hepatitis A rate during a baseline period of 1987-1997 was >20 cases per 100,000 population, approximately twice the national average, and for consideration of hepatitis A vaccination of children in those states and communities in which the average rate during the baseline period was at least the national average.<ref>[http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4812a1.htm CDC. Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1999;48(No. RR-12):1-37.]</ref>
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| In 2004, a total of 5,683 cases (rate: 1.9 cases per 100,000 population) were reported, representing an estimated 24,000 acute clinical cases when underreporting is taken into account. This rate was the lowest ever recorded and was 79% lower than the previously recorded low in 1992.<ref>CDC. Hepatitis surveillance. Report no. 61. Atlanta, GA: US Department of Health and Human Services, CDC. 2006</ref> This decline is reflected in other fundamental shifts in hepatitis A epidemiology.
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| ==References== | | ==References== |
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| {{Reflist|2}} | | {{Reflist|2}} |
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| [[Category:Needs content]] | | [[Category:Needs content]] |
| [[Category:Foodborne illnesses]] | | [[Category:Foodborne illnesses]] |
| [[Category:hepatitis|A]] | | [[Category:Hepatitis|A]] |
| [[Category:Picornaviruses]] | | [[Category:Picornaviruses]] |
| [[Category:Viral diseases]] | | [[Category:Viral diseases]] |
| [[Category:Mature chapter]] | | [[Category:Mature chapter]] |
| | [[Category:Disease]] |
| | [[Category:Emergency mdicine]] |
| | [[Category:Up-To-Date]] |
| [[Category:Infectious disease]] | | [[Category:Infectious disease]] |
| [[Category:Disease]] | | [[Category:Hepatology]] |
| | | [[Category:Gastroenterology]] |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Hepatitis A virus was first identified in 1973. It was classified as a separate disease from other types of hepatitis during World War II. However, its true prevalence and route of transmission would only be recognized later. During 1995-1996, the Food and Drug Administration (FDA) approved the inactivated hepatitis A vaccine. Consequently, hepatitis A became a disease that was not only common but also vaccine-preventable.
Historical Perspective
The earliest descriptions of diseases similar to Hepatitis A virus were reported 5000 years ago in China. Hippocrates also described a disease resembling hepatitis A that he called benign epidemic jaundice [1].
During the 17th century, outbreaks of hepatitis A were reported in military camps. In the US, first outbreak of more than 40,000 cases was reported in 1812 in Norfolk, VA. An estimated 16 million cases of hepatitis A were reported during the world war I and World War II [1].
Hepatitis A virus was first identified in 1973. In the US, hepatitis A vaccine was approved by the Food and Drug Administration (FDA) in 1995.
References
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