Hepatitis A Lawyer & Attorney : Marler Clark : Hepatitis A Blog

About a dozen states comply with the Centers for Disease Control (CDC) recommendations for vaccines for school-aged children.   The states have the power to enforce vaccine requirements at the school house door.

Since about 180,000 people become sick with Hepatitis A each year, and since that includes about 60,000 children, CDC recommends Hepatitis A vaccines for children entering Kindergarten for the 2009-10 school year. 

Here is the vaccine schedule as being enforced in Texas:

• Hepatitis A vaccine — Students entering Kindergarten must have two doses.
• Measles, mumps, rubella vaccine — Students entering Kindergarten must have two doses. Students in grades 1-12 must continue to meet the state requirements, which is two doses of a measles-containing vaccine and one dose each of mumps and rubella vaccine.
• Vericella vaccine — Students entering kindergarten and seventh grade must have had two doses. Students in grades 1-6 and 8-12 must continue to meet the state requirements.
• Tetanus, diphtheria, acellular peryussis-containing vaccine — Students entering seventh grade must have one dose of Tdap vaccine. Students in seventh grade must have had a booster dose of Tdap, but only if it has been five years since their last dose of a tetanus vaccine. Students in grades 8-12 must have had a booster dose of Tdap if it has been 10 years since their last dose.
•  Meningococcal vaccine — Students entering seventh grade must have one dose.

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Today (05/19/09) was Hepatitis Awareness Day in the United States and around the World. Many local health departments marked the occasion by offering free vaccines for Hepatitis A & B.

From the Connecticut Department of Public Health (DPH), we pass on this Hepatitis Awareness Day statement:

“Liver disease is a serious public health issue in our nation, as it currently affects more than 30 million Americans. Diseases such as Hepatitis are often referred to as “silent diseases” because liver damage can gradually occur over many years before being discovered, which often happens once the damage is irreparable,” stated DPH Commissioner Dr. J. Robert Galvin. “Nationally, hepatitis B and C are major causes of liver cancer, liver transplantation and even death.”

Hepatitis does not discriminate and affects all ages, genders, races, ethnicities and income levels. Learning about liver wellness, hepatitis A and B vaccination (there is no vaccine for hepatitis C), and risk factors are important ways to recognize and prevent the spread of these diseases.

Dr. Galvin added that “hepatitis A and B are vaccine preventable diseases, yet they continue to be the most commonly reported vaccine preventable diseases. Getting vaccinated, especially if you are at high risk, provides the best protection from these diseases.”

Connecticut mandates that all newborns, infants and school-age children be vaccinated against hepatitis B. All pregnant women should be tested for hepatitis B during their prenatal care so that measures can be taken to prevent transmission to newborns.

Hepatitis A is most often spread through ingesting contaminated food or water or by certain sexual practices and has been associated with large outbreaks of disease.

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 It use to be that if you were going to pick up children for adoption in a foreign country you were advised to get a Hepatitis A shot before departure.   In a new advisory, the Centers for Disease Control (CDC) says if you are going to come into "close contact" with newly adopted children from a foreign country, you should get a Hepatitis A vaccine even if you never leave the good old USA.

Reuters reports:

"Recently, there have been cases of family members who have gotten sick after kids have been adopted," said Dr. Cindy Weinbaum, a medical epidemiologist with the CDC. She said there had been about 20 cases, including a 51-year-old adoptive grandmother who became gravely ill.

Weinbaum said the recommendations cover adoptions from countries with a high or intermediate infection risk.

"That includes most of the world. All that (it) excludes is North America, Western Europe, Australia, New Zealand and Japan," she said.

For more on the CDC advisory, go here.

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One time exposure to contaminated food can give you the debilitating illness of Hepatitis A.
Now, however, comes word from the Centers for Disease Control and Prevention in Atlanta and the Alaska Native Tribal Health Consortium in Anchorage that the antibodies against Hepatitis A keep working for up to 27 years after vaccination.

Reuters Health, reporting on a recently published article in the Journal of Infectious Diseases, says:

Lead author Dr. Laura L. Hammitt, now at the Kenya Medical Research Institute/Welcome Trust Collaboration in Kilifi, and colleagues enrolled 144 children and 128 adults who responded to a three-shot series of hepatitis A vaccine to assess the persistence of antibodies.

The adults had received a primary dose of hepatitis A vaccine, with a second vaccination given 1 month later and a third given 12 months after the first.

The children were between 3 and 6 years of age and were given three doses at various intervals over the course of a year.

Hammitt's team collected blood samples 1 month after vaccination and again 1 to 10 years after vaccination to test for anti-hepatitis A antibodies. The researchers calculated long-term antibody persistence based on the observed rate of decline in concentrations.

"The estimated duration of antibody persistence was 21-27 years, depending on the vaccination schedule," Hammitt and colleagues write in the Journal of Infectious Diseases.

Get more from Reuters Health here.

 

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Whenever we get too critical of how quick and effective our governments are in North America when it comes to dealing in an up front and honest manner with we citizens, we have only look around the globe to understand how lucky we really are.

After China put pressure of its trial lawyers to drop food-borne illness claims in the Melamine scandal, we turn to South Africa to find a provincial government that just wants a city to cover up a Hepatitis A outbreak and more.

A little geography lesson first.   Mpumalanga is one of 9 provinces in South Africa, the nation of 50 million that is governed by Nelson Mandela's African National Congress.   There are over 3 million people living in Mpumalanga.

Bacterial diarrhea, hepatitis A, and typhoid fever are among the water and food-borne illnesses for which there is an intermediate risk in South Africa, according to international health experts.

So when the Municipality of Mbombela issued this warning...

“There is an outbreak of hepatitis A and meningitis around White River and Nelspruit. If one experiences one or more of symptoms like headache, fever, neck stiffness and fatigue, please consult the nearest clinic, hospital or your doctor.”

                                                                    ...it probably does not come as a surprise.

But guess who did not like it?  According to the Sowetan, a South African news service:

The Mpumalanga provincial government has ordered the Mbombela municipality to retract its warning to the public about outbreaks of meningitis and hepatitis in the area.

Provincial health department spokesman Mpho Gabashane said: “We only saw the warning statement released by the municipality, and at the moment we are yet to receive a formal report.”

While there appears to be some confusion between the municipality and the province, there are also indications that health-related news in the area are ripe with political overtones.  Go here, for more.

 

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Hepatitis A is the only common vaccine-preventable foodborne disease in the United States (Fiore, 2004).  It is one of five human hepatitis viruses that primarily infect the human liver and cause human illness.  Unlike hepatitis B and C, hepatitis A doesn’t develop into chronic hepatitis or cirrhosis which are both potentially fatal conditions (Mayo Clinic, 2006); however, hepatitis A infection can still lead to acute liver failure and death.

Hepatitis A is relatively uncommon in nations with developed sanitation systems such as the United States. Nevertheless, it continues to occur here, and approximately one-third of the United States population has been previously infected with hepatitis A (Fiore, 2004).

Viral hepatitis is a major public health concern in the United States, and a source of significant morbidity and mortality.  Each year, approximately 30 - 50,000 cases of hepatitis A occur in the United States.  Direct and indirect costs of these illnesses exceed $300 million, including wage loss and medical expenses.  Adults who become ill miss an average of 27 work days per illness.  Eleven to 12 percent of persons infected are hospitalized, and 100 people die as a result of acute liver failure annually in the United States due to hepatitis A (CDC, 2007).  The unfortunate aspect of these statistics is that with 21st Century medicine, hepatitis A is totally preventable and cases—especially outbreaks relegated to food consumption—need not occur.

The hepatitis A virus or “HAV” is relatively stable and will survive for up to a month at ambient temperatures in the environment, but can be inactivated by heating to 185°F (85°C) or higher, or exposure to formalin or chlorine.
Continue Reading...

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Hepatitis A is one of five human hepatitis viruses (hepatitis A, B, C, D, and E) that primarily infect the liver and cause illness. An estimated 80,000 cases occur each year in the U.S., although much higher estimates have been proposed based on mathematical modeling of the past incidence of infection. Each year, an estimated 100 persons die as a result of acute liver failure in the U.S. due to hepatitis A, but the rate of infection has dramatically decreased since the hepatitis A vaccine was licensed and became available in the U.S. in 1995.

Hepatitis A is a communicable (or contagious) disease that spreads from person-to-person. It is spread almost exclusively through fecal-oral contact, generally from person-to-person, or via contaminated food or water. Food contaminated with the virus is the most common vehicle transmitting hepatitis A. The food preparer or cook is the individual most often contaminating the food, although he or she is generally not ill at the time of food preparation. The peak time of infectivity, when the most virus is present in the stool of an infectious individual, is during the two weeks before illness begins. Although only a small percentage of hepatitis A infections is associated with foodborne transmission, foodborne outbreaks have been increasingly implicated as a significant source of hepatitis A infection.

Hepatitis A may also be spread by household contact among families or roommates, sexual contact, ingestion of contaminated water, ingestion of raw or undercooked fruits and vegetables or shellfish (like oysters), and from persons sharing illicit drugs. Children often have asymptomatic or unrecognized infections and can pass the virus through ordinary play to family members and other children and adults.

Symptoms of hepatitis A infection

Hepatitis A infection may cause no symptoms at all when it is contracted, especially in children. Such individuals will only know they were infected (and have become immune -- you can only get hepatitis A once) by getting a blood test later in life. The incubation period (from exposure to onset of symptoms) is 15-50 days, with an average of 30 days. Many children and most adults will experience the sudden onset of flu-like symptoms. After a day or two of muscle aches, headache, anorexia (loss of appetite), abdominal discomfort, fever and malaise, jaundice (also termed "icterus") sets in. Jaundice is a yellowing of the skin, eyes and mucous membranes that occurs because bile flows poorly through the liver and backs up into the blood. The urine will turn dark with bile and the stool will be light or clay-colored from lack of bile. When jaundice sets in, the initial symptoms begin to subside.

In general, the period of acute illness lasts from 10 days to three weeks, at which time affected individuals tend to recapture some sense of wellness. It is not unusual for blood tests to remain abnormal for six months (or more), prolonging recovery for up to a year. Most affected individuals show complete recovery within three to six months of the onset of illness. Relapse is possible, and although more common in children, it does occur with some regularity in adults.

Diagnosis and treatment of hepatitis A

There are blood tests widely available to accurately diagnose hepatitis A; blood samples are tested for hepatitis antibodies, which are present when the immune system responds to the hepatitis virus. Antibodies of the immune globulin (Ig) M variety, which indicate acute disease, and IgG antibodies, which stay positive for life, should both be measured.

Hepatitis A infection is an acute self-limiting disease. There is no specific treatment; treatment and management is merely supportive. The liver function tests generally improve as the affected individual begins to feel better. It is therefore well-accepted that the need for rest is best determined by the person's own perception of the severity of fatigue or malaise.

Preventing hepatitis A infection

Hepatitis A infection is totally preventable. Ill food-handlers should be excluded from work. Commercial food workers and other individuals who prepare food for others must always wash their hands with soap and water after using the bathroom, changing a diaper, and before preparing food. Cooking food to a temperature of 185 degrees F or higher will inactivate hepatitis A.

After a known exposure to hepatitis A, administration of a shot of immune globulin should be considered. If administered within two weeks of the exposure, it will usually be effective in preventing or at least ameliorating the disease.

Hepatitis A vaccine is the best protection from hepatitis A infection. The vaccine is recommended for persons traveling to areas with increased rates of hepatitis A, men who have sex with men, injecting and non-injecting drug users, persons with blood clotting factor disorders (such as hemophilia), persons with chronic liver disease, and children living in regions of the U.S. with increased rates of hepatitis A. The vaccine may also help protect household contacts of those with hepatitis A infection. Vaccination of food handlers would likely substantially diminish the incidence of hepatitis A outbreaks. The vaccine is licensed for individuals aged two and older, but there is good evidence that the vaccine is safe and effective at one year of age.

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