Viral Hepatitis A, 2003

In 2003, 52 cases of hepatitis A (1.1 per 100,000 population) were reported. Thirty-three (63%) cases were residents of the Twin Cities metropolitan area, including 25 (48%) residents of Hennepin or Ramsey Counties. Twenty-nine (56%) of the cases were male. Of 47 cases for whom race was reported, 38 (81%) were white, four (8%) were black, and five (11%) were Asian. Although the greatest number of case-patients were white, incidence rates were higher among Asians (3.1 per 100,000), and blacks (2 per 100,000), than among whites (0.9 per 100,000). Hispanic ethnicity, which can be any race, was reported for six cases (4.2 per 100,000). Case-patients ranged in age from one to 90 years.

Four (8%) case-patients were employees of four different food-serving establishments. No community transmission of hepatitis A was identified.

Of the 52 cases, a risk factor for infection was identified for 27 (52%). Three case-patients had known exposure to a confirmed hepatitis A case. One of these became infected following exposure in a childcare setting. The index case had recently traveled to Mexico and the subsequent case developed symptoms less than a month later. The entire childcare received immune globulin following the second case.

Of the remaining 24 (89%) cases with a risk factor identified, 21 (88%) were associated with travel (four of whom consumed raw shellfish). Of those, 16 (76%) traveled to Mexico or South America. One (4%) was a man who reported having sex with men (MSM), and two (8%) were adults with no reported risk factors other than working in childcare centers. Young children infected with hepatitis A are often asymptomatic or experience mild illness, but remain efficient transmitters of disease. Twenty-five (48%) cases had no identifiable risk factors.

Persons who travel to hepatitis A endemic countries and MSM should be educated about their risk of hepatitis A and offered hepatitis A vaccine.

• For up to date information see>> Hepatitis A
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2003