Viral Hepatitis A, 2008

In 2008, 49 cases of hepatitis A (0.9 per 100,000 population) were reported. Fourteen (29%) case-patients were residents of the metropolitan area, including 10 (20%) residents of Hennepin or Ramsey Counties. Twenty-four (49%) of the cases were male. Case-patients ranged in age from 5 to 84 years (median, 40 years). Thirty-six (73%) cases were white, two (4%) were black, and one (2%) was Asian; race was unknown for 10 (20%) cases. Only 3 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 three cases (1.5 per 100,000).

A risk factor was identified for 40 (82%) of the 49 cases, 13 (33%) 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 (IG). Of the remaining 27 (68%) cases with a risk factor identified, 7 (18%) were associated with travel. Of these seven case-patients, three (43%) traveled to Mexico, Central, or South America.

In 2008, there were two outbreaks of hepatitis A of 3 and 4 cases respectively. Three (6%) cases were associated with a food-borne outbreak from a potluck in Wabasha County (including the source case-patient). One daycare outbreak accounted for 4 (8%) cases. HAV is now recommended for post-exposure prophylaxis of certain groups. HAV used for post-exposure prophylaxis gives longer protection than IG, is often more readily available, and is easier to administer.

• For up to date information see>> Hepatitis A
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2008