| Such persons include tourists,
military personnel, mission personnel, and others who work or
study abroad in countries that have high or intermediate levels
of Hepatitis A. The risk for Hepatitis A exists even for travelers
to urban areas, those who stay in luxury hotels, and are careful
about what they drink and eat.
Children in states, counties, and communities where rates
of Hepatitis A were/are at least twice the national average
during the baseline period of 1987-1997. [Your local
health department should be able to tell you if you are living
in a high risk community.]
Children living in states, counties, and communities where rates of Hepatitis
A are at least twice the national average (greater than or equal to 20cases/1,000,000)
in the baseline period should be routinely vaccinated beginning at two years
of age. Vaccination of children before they enter school should receive highest
priority, followed by vaccination of older children who have not been vaccinated.
Men who have sex with men
Sexually active men (both adolescents and adults) who have sex with men should
be vaccinated. Hepatitis A outbreaks among men who have sex with men have
been reported frequently. Recent outbreaks have occurred in urban areas in
the United States, Canada, and Australia.
Persons who have chronic liver disease
Persons with chronic liver disease who have never had Hepatitis A should be
vaccinated, as there is a higher rate of fulminant (rapid onset of liver
failure, often leading to death) Hepatitis A among persons with chronic liver
disease. Persons who are either awaiting or have received liver transplants
also should be vaccinated.
Persons who have clotting-factor disorders
Persons who have never had Hepatitis A and who are administered clotting-factor
concentrates, especially solvent detergent-treated preparations, should be
given Hepatitis A vaccine.
All persons with hemophilia (Factor VIII, Factor IX) who receive replacement
therapy should be vaccinated because there appears to be an increased risk
of transmission from clotting-factor concentrates that are not heat inactivated.
Injecting drug users (legal or illegal)
Vaccination is recommended for all injecting drug users who share needles and
all those who use any illegal-drug—since the safety of the illegal
substance cannot be assured.
Those persons who have occupational risk for infection
including:
Health-care workers are not at increased risk
for Hepatitis A unless there is a breech in the hospital
infection control procedures. Routine precautions should
prevent transmission to hospital staff.
Day-care staff and attendees in locations where day-care
centers are playing a role in sustaining community-wide
outbreaks. In this situation, consideration should be given
to adding Hepatitis A vaccine to the prevention plan for
children and staff in the involved center(s).
Persons who work with Hepatitis A virus-infected primates
or with Hepatitis A virus in a research laboratory setting
should be vaccinated. No other groups have been shown to
be at increased risk for Hepatitis A virus infection because
of occupational exposure.
How is Hepatitis A prevented?
- Hepatitis A vaccination provides protection before one
is exposed to Hepatitis A virus. Hepatitis A vaccine has
been licensed in the United States for use in persons two
years of age and older for persons who are more likely to
get Hepatitis A virus infection or are more likely to get
seriously ill if they do get Hepatitis A.
- Short-term protection against Hepatitis A is available
from immune globulin. It can be given before and within two
weeks after coming in contact with HAV. Immune globulin is
a preparation of antibodies that provides short-term protection
for persons who have already been exposed to Hepatitis A
virus. It must be given within two weeks after exposure to
Hepatitis A virus for maximum protection.
- Always wash your hands with soap and water after using
the bathroom, changing a diaper, and before preparing and
eating food. One-third of Americans had evidence of past
infection (immunity).
- Food-borne outbreaks of Hepatitis A can originate from
foods prepared before the food handler has clinical symptoms.
Most reported outbreaks have been traced to symptomatic rather
than asymptomatic persons.
- Uncooked foods have most frequently been associated with
food-borne hepatitis because normal cooking temperatures
inactivate HAV. However, cooked foods handled after cooling
and foods that were contaminated and then cooked with insufficiently
high internal temperature to inactivate HAV have also been
implicated.
- Although poor hygiene practices among food handlers increase
the chance of transmission of virus, outbreaks have occurred
even when food handlers' personal hygiene practices were
described as "acceptable" and "generally good."
More information about Hepatitis A is found at www.cdc.gov/ncidod/diseases/Hepatitis/a/index.htm. |
