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U.S. hepatitis A rates slashed – study

July 12, 2005

CHICAGO (Reuters) – Cases of hepatitis A have fallen by 76
percent in the United States since children in communities with
the highest rates of the disease were targeted for vaccination
in recent years, a study said on Tuesday.

In the 1980s and 1990s, 26,000 cases of hepatitis A were
reported to public health officials each year, a fraction of
the cases that probably occurred but were not reported because
many victims do not have symptoms, the study said.

More than half of the estimated infections of the disease
– which can cause flu-like symptoms and jaundice — occurred
in children, the study from the U.S. Centers for Disease
Control and Prevention said.

Hepatitis is a viral infection that attacks the liver.
There are several varieties, and type A is considered less
threatening than some others that can cause liver failure and
death. Hepatitis A is spread by fecal contamination of water
and food.

A highly effective hepatitis A vaccine became available in
the United States for children age 2 or older in 1995,
according to the report in this week’s Journal of the American
Medical Association.

A year later medical experts recommended targeting
vaccinations toward children living in communities with higher
incidence of the disease such as Native American settlements.

Adults with high risk of the disease, such as men who have
sex with men, users of illegal drugs and travelers to countries
where the disease is endemic, were also targeted for
vaccinations.

In 1999, recommendations for routine vaccination were
expanded to include children living in 17 states that had
consistently elevated hepatitis A rates.

Cases fell 76 percent to 2.6 per 100,000 people in 2003
compared to the early and mid-1990s, researchers found.
Declines were greatest in children ages 2 to 18, at 87 percent,
the report said.

The regional, targeted vaccination approach appears to be a
novel one, the report said, but eliminating the disease would
require “expansion of existing recommendations to include
routine vaccination of all U.S. children.”

A second study on the subject published in the same journal
found that the overall incidence of hepatitis A fell by 95
percent in Israel since free routine vaccination of toddlers
began in 1999.




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