Central District Health Department Urges Health Care Providers to Watch

for Hepatitis A

February 26, 2019

Since the first of the year, six hepatitis A cases have been reported among Ada and Elmore County residents. Typically, 1-2 cases are reported in an entire calendar year. All reported cases have been men between the ages of 30 and 60. Only one case reported out-of-state travel during the most likely exposure period. No common risk factors for illness have been found.

Hepatitis A virus is typically spread person-to-person through fecal-oral transmission. Older children and adults usually develop jaundice, but young children are often asymptomatic. The average incubation period for hepatitis A is 28 days with a range of 15-50 days, and most cases are self-limited.

Symptoms and Laboratory Testing

Hepatitis A diagnosis is based on a discrete onset of symptoms consistent with hepatitis (e.g., nausea, anorexia, fever, malaise, or abdominal pain) AND jaundice and/or elevated serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels. The symptoms of hepatitis A are indistinguishable from those caused by other types of acute viral hepatitis.

Recommended testing includes liver function testing and acute viral hepatitis testing with hepatitis A IgM, hepatitis B core IgM, hepatitis B surface antigen, and hepatitis C antibody. Please note, hepatitis A total antibody does not distinguish acute infection from past infection or immunity, so it is not recommended.

Prevention

Although routine vaccination for hepatitis A is always recommended for anyone who wants to prevent infection, exposed individuals will not benefit from prophylaxis unless the vaccine or immunoglobulin is given within 14 days of exposure. Please visit https://www.cdc.gov/hepatitis/hav/havfaq.htm#protection to view the current hepatitis A post-exposure prophylaxis guidelines.

Please contact Communicable Disease Control at (208) 327-8625 to report suspect and confirmed cases of hepatitis A.

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