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Sources of infection among persons with acute hepatitis A and no identified risk factors during a sustained community-wide outbreak.
Pediatrics. 2000 Oct; 106(4):E54.Ped

Abstract

CONTEXT

Hepatitis A is a common vaccine-preventable disease in the United States. Most cases occur during community-wide outbreaks, which can be difficult to control. Many case-patients have no identified source.

OBJECTIVE

To identify foodborne and household sources of hepatitis A during a community-wide outbreak.

DESIGN

Serologic and descriptive survey.

SETTING

Salt Lake County, Utah.

PARTICIPANTS

A total of 355 household contacts of 170 persons reported with hepatitis A during May 1996 to December 1996, who had no identified source of infection; and 730 food handlers working in establishments where case-patients had eaten.

MAIN OUTCOME MEASURE

Prevalence of immunoglobulin M antibodies to hepatitis A virus (IgM anti-HAV) among household and food service contacts.

RESULTS

Overall, 70 household contacts (20%) were IgM anti-HAV-positive, including 52% of children 3 to 5 years old and 30% of children <3 years old. In multivariate analysis, the presence of a child <3 years old (odds ratio [OR]: 8.8; 95% confidence limit [CL]: 2.1,36) and a delay of >/=14 days between illness onset and reporting (OR: 7. 9; 95% CL: 1.7,38) were associated with household transmission. Of 18 clusters of infections linked by transmission between households, 13 (72%) involved unrecognized infection among children <6 years old. No food handlers were IgM anti-HAV-positive.

CONCLUSION

During a community-wide outbreak, HAV infection among children was common, was frequently unrecognized, and may have been an important source of transmission within and between households. Transmission from commercial food establishments was uncommon. Ongoing vaccination of children may prevent future outbreaks.

Authors+Show Affiliations

Salt Lake City-County Health Department, Salt Lake City, Utah, USA. catherine.staes@hsc.utah.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

11015549

Citation

Staes, C J., et al. "Sources of Infection Among Persons With Acute Hepatitis a and No Identified Risk Factors During a Sustained Community-wide Outbreak." Pediatrics, vol. 106, no. 4, 2000, pp. E54.
Staes CJ, Schlenker TL, Risk I, et al. Sources of infection among persons with acute hepatitis A and no identified risk factors during a sustained community-wide outbreak. Pediatrics. 2000;106(4):E54.
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(4), E54.
Staes CJ, et al. Sources of Infection Among Persons With Acute Hepatitis a and No Identified Risk Factors During a Sustained Community-wide Outbreak. Pediatrics. 2000;106(4):E54. PubMed PMID: 11015549.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sources of infection among persons with acute hepatitis A and no identified risk factors during a sustained community-wide outbreak. AU - Staes,C J, AU - Schlenker,T L, AU - Risk,I, AU - Cannon,K G, AU - Harris,H, AU - Pavia,A T, AU - Shapiro,C N, AU - Bell,B P, PY - 2000/10/4/pubmed PY - 2001/2/28/medline PY - 2000/10/4/entrez SP - E54 EP - E54 JF - Pediatrics JO - Pediatrics VL - 106 IS - 4 N2 - CONTEXT: Hepatitis A is a common vaccine-preventable disease in the United States. Most cases occur during community-wide outbreaks, which can be difficult to control. Many case-patients have no identified source. OBJECTIVE: To identify foodborne and household sources of hepatitis A during a community-wide outbreak. DESIGN: Serologic and descriptive survey. SETTING: Salt Lake County, Utah. PARTICIPANTS: A total of 355 household contacts of 170 persons reported with hepatitis A during May 1996 to December 1996, who had no identified source of infection; and 730 food handlers working in establishments where case-patients had eaten. MAIN OUTCOME MEASURE: Prevalence of immunoglobulin M antibodies to hepatitis A virus (IgM anti-HAV) among household and food service contacts. RESULTS: Overall, 70 household contacts (20%) were IgM anti-HAV-positive, including 52% of children 3 to 5 years old and 30% of children <3 years old. In multivariate analysis, the presence of a child <3 years old (odds ratio [OR]: 8.8; 95% confidence limit [CL]: 2.1,36) and a delay of >/=14 days between illness onset and reporting (OR: 7. 9; 95% CL: 1.7,38) were associated with household transmission. Of 18 clusters of infections linked by transmission between households, 13 (72%) involved unrecognized infection among children <6 years old. No food handlers were IgM anti-HAV-positive. CONCLUSION: During a community-wide outbreak, HAV infection among children was common, was frequently unrecognized, and may have been an important source of transmission within and between households. Transmission from commercial food establishments was uncommon. Ongoing vaccination of children may prevent future outbreaks. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/11015549/Sources_of_infection_among_persons_with_acute_hepatitis_A_and_no_identified_risk_factors_during_a_sustained_community_wide_outbreak_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&amp;pmid=11015549 DB - PRIME DP - Unbound Medicine ER -