Winning the War on Hepatitis A
January 27, 2003
Cases of hepatitis A have dropped dramatically in Southern California and much of the West over the last few years -- and experts credit, in large part, the widespread vaccination of children against the most common liver disease. Most of the drop has been among Latino children, who traditionally have a rate of hepatitis A so high that a University of California-Los Angeles medical school study of the early 1990s pre-vaccine years called it an epidemic.Adapted from:
Hepatitis A is transmitted through fecal and oral contact (usually spread when carriers do not wash their hands); through contaminated food or water; or through sexual contact. Symptoms are similar to the flu and include jaundice. Most people recover within three months, and the disease confers lifetime immunity. While not as severe as hepatitis B or C, hepatitis A takes a toll, causing adult patients to miss an average of 27 days of work, according to CDC, and killing about 100 people a year.
In Orange County, the number of hepatitis A cases among Latinos 18 and younger has dropped 91 percent from 2000 to 2002, from 107 to 10, statistics show. In Los Angeles County, cases among Latinos 14 and under have dropped from 368 in 1999 to 114 in 2001, a 69 percent decrease. When all of the data for 2002 are in, state health officials say they expect that for the first time there will have been more hepatitis A cases in adults than in children.
"The idea is if you vaccinate children, not only do you prevent infections in children, but you prevent them in adults," said Dr. Beth P. Bell, chief epidemiologist in the National Center for Infectious Disease viral hepatitis division. Children can be vaccinated at age two, with two shots given six months apart. Several states, including Oklahoma and Alaska, have made the vaccinations mandatory. Although it remains voluntary in California, many doctors include hepatitis A shots among the 20 or so vaccinations youngsters receive.
Nationally, hepatitis A incidence had already been declining since the mid-1970s, probably as a result of improved sanitation. According to CDC, hepatitis A cases in states where vaccinations were recommended dropped 83 percent when the average rate from 1987-1997 is compared with 2001. Elsewhere in the nation, the rate fell 39 percent.
Los Angeles Times
01.19.03; Jeff Gottlieb