Viral Hepatitis A, 2006

In 2006, 31 cases of hepatitis A (0.6 per 100,000) were reported. Seventeen (55%) case-patients were residents of the metropolitan area, including eight (26%) residents of Hennepin or Ramsey Counties. Sixteen (52%) of the cases were male. Case-patients ranged in age from 3 to 76 years (median, 25 years). Race was reported for 18 (58%) cases, of whom 14 (78%) were white, two (11%) were Asian, one (6%) was black, and one (6%) was of other race. No cases have been reported in American Indians since 2002. The incidence rate of hepatitis A in American Indians declined steadily from 10.4 per 100,000 in 1999 to 6.0, 3.7, and 2.5 per 100,000, in 2000, 2001, and 2002 respectively, demonstrating the success of targeted immunization efforts initiated in 1999. Hispanic ethnicity was reported for 12 cases (6.1 per 100,000).

One (3%) case-patient was an employee of a commercial food establishment. No community transmission of hepatitis A was identified.

A risk factor was identified for 28 (90%) of the 31 cases, two (7%) of whom had known exposure to a confirmed hepatitis A case. These persons became infected following exposure to a close contact, representing missed opportunities to administer immune globulin.

Of the remaining 26 (84%) cases with a risk factor identified, 16 (62%) were associated with travel. Of these 16, 13 (81%) traveled to Mexico, Central, or South America, three of whom reported consuming raw shellfish. Hepatitis A vaccine is recommended routinely for all children ages 12-23 months, as well as for persons who are at increased risk of infection (including persons who travel to countries with hepatitis A virus endemicity, and men who have sex with men, and for any person wishing to obtain immunity) (CDC. Prevention of hepatitis A through active or passive immunization: Recommendations of the Advisory Committee on Immunization Practices [ACIP] MMWR 2005;55[No. RR-7]:1-23). Universal hepatitis A vaccination of children is intended to further reduce hepatitis A morbidity and mortality in the United States, and make eventual elimination of HAV transmission a possibility.

• For up to date information see>> Hepatitis A
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2006