Vaccine Quells Hepatitis A Outbreak

Immunizing kids cuts community infection rate dramatically, finds study

TUESDAY, Dec. 18, 2001 (HealthDayNews) -- Immunizations don't just protect those who get them -- they also can reduce the amount of disease in the community around them.

A study by the Centers for Disease Control and Prevention (CDC) found when children in one California county were offered free hepatitis A vaccines, the rate of the liver infection went down almost 95 percent for both children and adults in that area.

"We wanted to see whether we could affect hepatitis rates in the larger community by vaccinating the children in the community," says Dr. Beth P. Bell, one of the study's authors from the CDC's division of viral hepatitis, in Atlanta.

Hepatitis A is a viral infection that is spread by fecal-to-mouth contamination, mostly from close personal contact, poor hygiene or contaminated food or water. Bell says person-to-person transmission is the most frequent way the virus spreads in the United States, not from contaminated food. The infection, which causes the liver to swell, lasts about four weeks. Symptoms include fever, fatigue, nausea, vomiting, yellow skin or eyes, abdominal pain, diarrhea and loss of appetite. Hepatitis A, the most common of the various forms of hepatitis in the United States, infects about 134,000 people every year, reports the Hepatitis Information Network.

The infection often causes community-wide outbreaks, and children usually play a significant role in the spread of the infection, Bell says. A vaccine for hepatitis A became available in the United States in 1995.

To see if the vaccine could control recurrent outbreaks, the researchers offered free immunizations to children ages 2 to 12 in Butte County, Calif., where repeated outbreaks of hepatitis A have occurred since 1985.

From January 1995 through December 2000, the CDC offered the free vaccine in school clinics, health department clinics and through private health-care providers. Almost 30,000 children received the first dose of the vaccine, and more than 17,000 got a second dose during the study. Two doses of the vaccine are recommended for long-term protection, says Bell. The hepatitis A vaccine is believed to be about 98 percent effective in stopping the disease. No serious side effects were reported from the vaccines.

The total number of infections went from 57 in 1995 to just four in 2000, the lowest rate of hepatitis A infections in the county since officials started keeping records on the disease in 1966. In 2000, Butte County also had the lowest rate of hepatitis A of any California county.

The findings appear in the current issue of the Journal of the American Medical Association.

"This study shows it's a very safe and effective vaccine, and if you live in an area with hepatitis A, you should feel very comfortable about immunizing your children," says Dr. Jane Siegel, chairwoman of the infection control committee at Children's Medical Center of Dallas. "It's also important for people that are traveling to somewhere where hepatitis A is endemic."

What To Do

Talk to your doctor about the hepatitis A vaccine if you live in a high-risk area or will be traveling to one.

Other ways to prevent the disease include proper hygiene. Always wash your hands after going to the bathroom and before eating; use bottled water and don't use ice in drinks when traveling to other countries.

For more information on hepatitis A and ways to prevent it, go to the National Digestive Diseases Information Clearinghouse or the National Foundation for Infectious Diseases.

The New York City Department of Health offers information on the hepatitis A vaccine.

SOURCES: Interviews with Beth P. Bell, M.D., M.P.H., division of viral hepatitis, CDC, Atlanta; Jane Siegel, M.D., professor of pediatrics, University of Texas Southwestern, chairman of infection control committee, Children's Medical Center of Dallas, Texas; Dec. 19, 2001, Journal of the American Medical Association
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