Diners who ate at the restaurant at 4009 S. Loop 289 from Aug. 31 through Sept. 8 may have been exposed, said Lubbock Health Director Bridget Faulkenberry.

The employee, who worked in food preparation, has not worked at the restaurant since Sept. 8, Faulkenberry said.

Meanwhile, the city is working to obtain vaccine to offer anyone who patronized the restaurant during that period. Information about immunization clinics will be announced when the vaccine is available.

See all at www.hepatitislitigation.com

Although there are no known drugs for the treatment of Hepatitis A, there are a number of preventive Hepatitis A drug treatments as well as vaccines that can be used as a precautionary method especially in developing countries where the incidence of Hepatitis A is quite high.

Some of the vaccines as well as the drug treatments for Hepatitis A include:

1. HAVRIX is a good drug treatment for Hepatitis A and is a vaccine that is used to help prevent Hepatitis A in adults. This vaccine works by exposing the body to a small and harmless amount of the virus to enhance the immunity of the body against Hepatitis A by increasing the production of antibodies against it. Vaccination with HAVRIX is essential for all adults travelling to areas or countries where the pathogenicity of the virus is high, including developing nations. It is also essential to be vaccinated by HAVRIX if the person is suffering from a liver disease, uses IV drugs, or receives any blood transfusion where the transmission of the virus is a threat. Working with laboratory animals may also put a person at risk of being exposed to the Hepatitis A virus.

2. VAQTA is also another vaccine used to treat Hepatitis A, which has the same mechanism as HAVRIX. This drug treatment of Hepatitis A can be administered to anyone who is older than 12 months and who is at a risk of infection by the virus. The vaccine may be injected in the muscles of the shoulder by a healthcare professional. A series of two injections can be administered over the course of six to 18 months. The dosage depends on the age of the person.

3. Another vaccine used for the treatment of Hepatitis A is TWINRIX, which is supplied as a sterile suspension that is administered intramuscularly. The vaccine is a combination of the Hepatitis A inactivated as well as Hepatitis B Recombinant vaccine and unlike VAQTA and HAVRIX, it can treat both Hepatitis A as well as B.

4. Dosages of Immune Globin or IG can also be given to people at risk of this disease. This vaccine is usually given intramuscularly into either the deltoid or gluteal muscles to children above the age of 12 months.

5. Other drug treatments for Hepatitis A that are highly effective are supportive treatments used to cure the accessory symptoms of the disease such as jaundice, depression, abdominal pains, etc.

“Foodborne illness outbreaks can affect a great many people,” said Marler Clark managing partner Bill Marler. “With this donation, we want to encourage young minds to consider science, in the hopes that the next generation can improve food safety for all of us.”

Health department officials say that people who ate at Quiznos at 30 East Broadway (300 South) in Salt Lake City on August 6 and 7 may be at risk for developing hepatitis A and should receive an injection of immune globulin (IG) or hepatitis A vaccine as soon as possible. These people can obtain a vaccination at the SLVHD City Clinic at 610 South 200 East today (August 19) until 5pm, tomorrow (August 20) from 8:30am to 6:30pm and Saturday (August 21) from 8:00am to 12 noon. The cost of vaccinations will be covered by Quiznos.

People who ate at the restaurant on these dates and who are not currently in the Salt Lake valley area are urged to contact their state or local public health department or their health care provider.

Additionally, people who ate at the restaurant between July 27th and August 5th may also have been exposed but would not benefit from the immunizations because immunizations must be given within 14 days of exposure. These people should watch for signs of hepatitis A and contact their health care provider if they develop illness.

Immune globulin and/or the hepatitis A vaccine can prevent infection if given within 14 days of exposure. People between ages 1 and 40 can receive hepatitis A vaccine; infants and people over 40 should receive immune globulin. If you have received the hepatitis A vaccine series, you do not need to be revaccinated.

Early signs of hepatitis A appear 2-6 weeks after exposure. Symptoms commonly include an abrupt onset of fever, loss of appetite, nausea, vomiting, diarrhea, tiredness, pain in the upper right side of the abdomen, dark urine and jaundice (yellowness of eyes or skin).

The disease varies in severity, with mild cases lasting two weeks or less and more severe cases lasting 4-6 weeks or longer. Some individuals, especially children, may not develop jaundice and may have an illness so mild it can go unnoticed. However, even mildly ill persons can be highly infectious. Persons with symptoms suggestive of hepatitis should consult a physician immediately, even if symptoms are mild.

Hepatitis A virus is spread as a result of fecal contamination (fecal-oral route) and may be spread from person to person through close personal or intimate contact or through food handling. The virus is commonly spread by contaminated food or beverages. Persons are at increased risk of acquiring hepatitis A when they have been in close and continuous contact with an infected person.

Quiznos Restaurant Inspection Information No other Quiznos restaurants have been affected by this Hep A exposure. SLVHD restaurant inspection records show that the Quiznos restaurant has had very good inspections in the past and the restaurant management is cooperating fully with the investigation. There are no other confirmed hepatitis A cases related to the restaurant at this time and the restaurant is still open for business. There is no risk of exposure at this time.

While about-hepatitis.com is informational in purpose, the hepatitis A blog is intended to be a forum for discussion among the site's authors and users. The authors of the hepatitis A blog conduct surveillance on matters related to hepatitis A's impact on individuals and families in different cities, states, and regions.

Please join us in a conversation about hepatitis A that includes subjects such as outbreaks, recalls, and legal cases by commenting on posts that you find interesting

About hepatitis A (HAV)

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; however, infection with the hepatitis A virus (HAV) can still lead to acute liver failure and death.

Hepatitis A is much more common in countries with underdeveloped sanitation systems. This includes most of the world: an increased transmission rate is seen in all countries other than the United States, Canada, Japan, Australia, New Zealand, and the countries of Western Europe. Nevertheless, it continues to occur in the United States; approximately one-third of the population has been previously infected with HAV (Fiore, 2004; Centers for Disease Control and Prevention [CDC], 2009a). Each year, approximately 30,000 to 50,000 cases of hepatitis A occur in the United States. Although the national incidence (1.0 case per 100,000 population) of hepatitis A was the lowest ever recorded in 2007, it is estimated that 25,000 new infections occurred that year after asymptomatic infection and underreporting were taken into account.

In 2007, a total of 2,979 acute symptomatic cases of hepatitis A were reported (CDC, 2009b). Among the 1,047 cases with available information regarding foodborne or waterborne exposure, 6.5% were found to be foodborne or waterborne related, about one-third the proportion reported at the last peak in 2003. However, 2500 cases remained without known risk factors.

Estimates of the annual direct and indirect costs of hepatitis A in the United States have ranged from $300 million to $488.8 million in 1997 dollars (CDC, 2007). Nationwide, adults who become ill miss an average of 27 work days per illness and 11 to 22 percent of those infected are hospitalized (CDC, 2009c). These are avoidable illnesses, since 21st Century medicine and the advent of hepatitis A vaccine have rendered hepatitis A infections totally preventable.

How is Hepatitis A Infection Transmitted?

HAV is relatively stable and can survive for several hours on fingertips and hands and up to two months on dry surfaces, but can be inactivated by heating to 185°F (85°C) or higher for one minute or disinfecting surfaces with a 1:100 dilution of sodium hypochlorite (household bleach) in tap water (Advisory Committee on Immunization Practices [ACIP], 2006; CDC, 2009c; Todd et al., 2009). However, HAV can still be spread from cooked food if it is contaminated after cooking.

Although ingestion of contaminated food is a common means of spread for hepatitis A, it may also be spread by household contact among families or roommates, sexual contact, by the ingestion of contaminated water or shellfish (like oysters), and by direct inoculation from persons sharing illicit drugs. Children often have asymptomatic or unrecognized infections and can pass the virus through ordinary play, unknown to their parents, who may later become infected from contact with their children.


What are the symptoms of Hepatitis A Infection?

Hepatitis A 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. Symptoms typically begin about 28 days after contracting HAV, but can begin as early as 15 days or as late as 50 days after exposure and include muscle aches, headache, anorexia (loss of appetite), abdominal discomfort, fever, and malaise. After a few days of the aforementioned symptoms, 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 also turn dark with bile and the stool light or clay-colored from lack of bile. When jaundice sets in, the initial systemic manifestations (such as fever and headache) begin to subside.

In general, symptoms usually last less than 2 months, although 10% to 15% of symptomatic persons have prolonged or relapsing disease for up to 6 months. It is not unusual, however, for blood tests to remain abnormal for six months or more. The jaundice so commonly associated with hepatitis A can linger for a prolonged period in some infected persons – sometimes as long as eight months. Additionally, pruritus, or severe “itchiness” of the skin, can also persist for several months after the onset of symptoms. These conditions are frequently accompanied by diarrhea, anorexia, and fatigue. Relapse is possible with hepatitis A, typically within three months of the initial onset of symptoms. Although relapse is more common in children, it does occur with some regularity in adults. The vast majority of persons who contract hepatitis A fully recover, and do not develop chronic hepatitis. Persons do not carry hepatitis A long-term as with hepatitis B and C.

Fulminant hepatitis A is a rare but devastating complication of an HAV infection; as many as 50% of individuals with acute liver failure may die or require emergency liver transplantation (Taylor et al., 2006). Elderly patients and patients with chronic liver disease are at a higher risk of fulminant hepatitis A. In parallel with a declining incidence of acute HAV infection in the general population, however, the incidence of fulminant HAV appears to be decreasing (Taylor et al., 2006).

How is Hepatitis A Infection Diagnosed?

At onset, the various human hepatitis viruses cause very similar illnesses. Therefore, neither the individual nor the healthcare provider can tell by symptoms or signs if a given individual is suffering from hepatitis A. 


Fortunately, blood tests are widely available to accurately diagnose hepatitis A. These are tests for antibodies, or the affected person’s immune response to hepatitis A proteins. Immunoglobulin M (IgM) antibodies, which indicate acute disease, and immunoglobulin G (IgG) antibodies, which stay positive for life, should both be measured. Following is the interpretation of the results:


 * IgM negative / IgG negative: Most persons with these results have never contracted hepatitis A. Antibodies of the IgM variety develop five to ten days prior to the onset of symptoms.

 * IgM positive / IgG negative: This result indicates acute hepatitis A.

 * IgM positive / IgG positive: This result indicates that acute hepatitis A occurred within the last six months. By six months, the IgM reverts to negative.

 * IgM negative / IgG positive: Persons with this result are immune to hepatitis A. They have either been infected with the virus months or years in the past (with or without symptoms), or they have been vaccinated for hepatitis A. However, if they are currently ill, it is not likely to be due to hepatitis A.

Treatment for Hepatitis A Infection (Viral Hepatitis)

Once a clinical infection is established, there is no specific treatment for hepatitis A. Affected individuals generally suffer from loss of appetite, so the main concern is ensuring a patient receives adequate nutrition and avoids permanent liver damage (Mayo Clinic, 2009). An individual’s perception of the severity of fatigue or malaise is the best determinant of the need for rest.

Treatment of those suffering from fulminant hepatic failure depends largely on the affected person’s status. Those who have not developed brain complications, like encephalopathy or cerebral edema, generally undergo an intense course of supportive treatment. But for those whose liver failure is so complete that it has led to these complications, timely liver transplantation is often the only option. Unfortunately, many individuals with irreversible liver failure do not receive a transplant because of contraindications or the unavailability of donor livers (Feldman, 2002). 


How to Prevent Hepatitis A Infection


Hepatitis A is TOTALLY PREVENTABLE. Although outbreaks continue to occur in the United States, outbreaks NEED NOT OCCUR if responsible preventive measures are taken. Food handlers must always wash their hands with soap and water after using the bathroom, changing a diaper, and certainly before preparing food. Food handlers should always wear gloves when handling or preparing ready-to-eat foods, although gloves are not a substitute for good hand washing. Ill food-handlers should be excluded from work.

After exposure, immune globulin (IG) is 80% to 90% effective in preventing clinical hepatitis A when administered within 2 weeks of last exposure (CDC, 2007). Efficacy is greatest when IG is administered early in the incubation period; when administered later in the incubation period, IG might only attenuate the clinical expression of HAV infection. The Advisory Committee on Immunization Practices (ACIP) recommends IG exclusively for postexposure (CDC, 2007). Hepatitis A vaccine, if recommended for other reasons, could be given at the same time.

In 2006, the ACIP recommended routine hepatitis A vaccination for all children ages 12-23 months, that hepatitis A vaccination be integrated into the routine childhood vaccination schedule, and that children not vaccinated by two years of age be vaccinated subsequently (ACIP, 2006). The vaccine is recommended for the following persons:

* Travelers to areas with increased rates of hepatitis A
* Men who have sex with men
* Injecting and non-injecting drug users
* Persons with clotting-factor disorders (e.g. hemophilia)
* Persons with chronic liver disease
* Persons with occupational risk of infection (e.g. those who work with hepatitis A-infected primates or with hepatitis A virus in a laboratory setting)
* Children living in regions of the U.S. with increased rates of hepatitis A
*Household members and other close personal contacts (such as regular babysitters) of adopted children newly arriving from countries with high or intermediate rates of hepatitis A (CDC, 2009d)

The vaccine may also help protect household contacts of those persons infected with hepatitis A (CDC, 2009c; Sagliocca, et al., 1999). Although generally not a legal requirement at this time, vaccination of food handlers would be expected to substantially diminish the incidence of hepatitis A outbreaks. Persons traveling to a high-risk area less than four weeks after initial dose of hepatitis A vaccine, or travelers who choose not to be vaccinated against hepatitis A should receive a single dose of Immune Globulin, which provides protection against hepatitis A infection for up to three months (CDC, 2009c; Piazza, et al., 1999).


Outbreaks

* Carl’s Jr. Hepatitis A Outbreak

* Chi-Chi’s Hepatitis A Outbreak

* D’Angelo’s Hepatitis A Outbreak

* Friendly’s Hepatitis A Exposure

* Maple Lawn Dairy Hepatitis A Outbreak

* McDonald’s Hepatitis A Outbreak

* Quizno’s Hepatitis A Exposure

* Silver Grill Catering Hepatitis A Outbreak

* Subway Hepatitis A

Outbreak 

References

Advisory Committee on Immunization Practices (ACIP), Fiore AE, Wasley A, Bell BP. (2006). Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP).

MMWR Recomm Rep.55(RR-7):1-23.
Bialek SR, Thoroughman DA, Hu D, Simard EP, Chattin J, Cheek J, Bell BP. (2004).

Hepatitis A Incidence and Hepatitis A Vaccination Among American Indians and Alaska Natives, 1990–2001. Am J Public Health. 94(6):996-1001.
Bownds L, Lindekugel R, Stepak P. (2003).

Economic impact of a hepatitis A epidemic in a mid-sized urban community: the case of Spokane, Washington. J Community Health. 28(4):233-246.
Butot S, Putallaz T, Sánchez G. (2008).

Effects of sanitation, freezing and frozen storage on enteric viruses in berries and herbs. Int J Food Microbiol. 126(1-2):30-35.
Calder L, Simmons G, Thornley C, Taylor P, Pritchard K, Greening G, Bishop J. (2003).

An outbreak of hepatitis A associated with consumption of raw blueberries. Epidemiol Infect. 131(1):745-751.
Centers for Disease Control and Prevention (2009a).

Disease Burden from Viral Hepatitis A, B, and C in the United States. Available at http://www.cdc.gov/hepatitis/PDFs/disease_burden.pdf).
Centers for Disease Control and Prevention (2009b).

Surveillance for Acute Viral Hepatitis --- United States, 2007. Surveillance Summaries. 58 (SS03):1-27.
Centers for Disease Control and Prevention (2009c).

Hepatitis A. In: Epidemiology and Prevention of Vaccine-Preventable Diseases. Atkinson W, Wolfe S, Hamborsky J, McIntyre L, eds. 11th ed. Washington DC: Public Health Foundation, pp. 85-97.


Centers for Disease Control and Prevention (2009d). Updated recommendations from the Advisory Committee on Immunization Practices (ACIP) for use of hepatitis A vaccine in close contacts of newly arriving international adoptees. Centers for Disease Control and Prevention (CDC); Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep. 58(36):1006-7.
CDC (2007).

Update: Prevention of Hepatitis A after Exposure to Hepatitis A Virus and in International Travelers. Updated Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 56(41);1080-1084.
Detry O, De Roover A, Honore P, Meurisse M. (2006).

Brain edema and intracranial hypertension in fulminant hepatic failure: pathophysiology and management. World J Gastroenterol. 12: 7405-7412.
Feldman, M, Friedman, LS, Sleisenger, MH. (2002). Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 7th ed. [2-volume set]. St. Louis, MO: Saunders. 80: 1571.
Fiore, AE. ( 2004).

“Hepatitis A Transmitted by Food.” Clinical Infectious Diseases. 38:705-715.
Gilkson M, Galun E, Oren R, Tur-Kaspa R, Shouval D. (1992).

Relapsing hepatitis A. Review of 14 cases and literature survey. Medicine. 71:14-23.
Hutin YJF, Pool V, Cramer EH, et al. (1999).

A multistate, foodborne outbreak of hepatitis A. N Engl J Med. 340:595–602.
Jaykus L. (1997).

Epidemiology and Detection as Options for Control of Viral and Parasitic Foodborne Disease. Emerg Infect Dis. 3(4):529-539.
Mayo Clinic. (2009).

Hepatitis A. Available at http://www.mayoclinic.com/health/hepatitis-a/DS00397.

Piazza M, Safary A, et al. (1999).

Safety and immunogenicity of hepatitis A vaccine in infants: a candidate for inclusion in the childhood vaccination program. Vaccine. 17:585-588.
Rawls RA and Vega KJ (2005).

Viral Hepatitis in Minority America. J Clin Gastroenterol. 39:144–151.
Sagliocca L, Amoroso P, et al. (1999).

Efficacy of hepatitis A vaccine in prevention of secondary hepatitis A infection: A randomized trial. Lancet. 353:1136-39.
Scharff RL, McDowell J, Medeiros L. (2009).

Economic Cost of Foodborne Illness in Ohio. J Food Prot. 72(1):128-136.
Schiff ER. (1992).

Atypical Manifestations of hepatitis-A. Vaccine. 10(Suppl. Vol. 1): 18-20.
Taylor R, Davern T, Munoz S, Han S-H, McGuire B, Larson AM, et al. (2006).

Fulminant hepatitis A virus infection in the United States: incidence, prognosis, and outcomes. Hepatology. 44:1589-1597.
Todd EC, Greig JD, Bartleson CA, Michaels BS. (2009).

Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 6. Transmission and survival of pathogens in the food processing and preparation environment. J Food Prot. 72(1):202-219.
Wheeler C, Vogt TM, Armstrong GL, et al. (2005).

An Outbreak of Hepatitis A Associated with Green Onions. N Engl J Med. 353: 890-897.
Willner IR, Uhl MD, Howard SC, Williams EQ, Riely CA, Waters B. (1998).

Serious hepatitis A: an analysis of patients hospitalized during an urban epidemic in the United States. Ann Intern Med. 128:111-114.

Hepatitis A is a serious liver disease caused by the hepatitis A virus. It is the most common type of hepatitis and it can range from mild "flu-like" symptoms to sudden and severe onset liver failure. One in five people are actually hospitalized because of hepatitis A. Some common symptoms are feeling very tired, sick to your stomach, losing weight without trying, pain on the right side of the belly, under the rib cage, a fever or sore muscles. Additionally, older adults may have jaundice (yellow skin), along with dark urine and clay-colored stools.

How is hepatitis A spread? The virus is found in the stool of an infected person. It is spread when a person eats food or drinks water that has come in contact with infected stool. This can happen when an employee with hepatitis A does not wash his or her hands after using the bathroom and then prepares food. The same is true in a daycare center when workers do not wash their hands after changing a diaper.

Another way of contracting hepatitis A is by eating raw oysters or undercooked clams. Similarly, if you travel to a country where hepatitis A is common and you eat uncooked foods or drink tap water, you may contract the virus.

GET VACCINATED

A simple way you can protect yourself from hepatitis A is to get the vaccine. This involves a series of two shots and they are usually 100 percent effective when you get them both before you are exposed to the virus.

A vaccine, like any medicine, could possibly cause serious problems, such as a severe allergic reaction. However, the risk of hepatitis A vaccine causing serious harm, or death, is extremely small and getting a shot is much safer than getting the disease.

Some mild problems include soreness where the shot was given, headache, loss of appetite, and tiredness. Severe problems, which are very rare, would be an allergic reaction that would occur within a few minutes to a few hours of the shot. Signs of a serious allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heartbeat or dizziness.

There are certain people in the community who should be routinely vaccinated with the hepatitis A vaccine. First, all children age 1, and anyone age 1 and older traveling to or working in countries with high or intermediate prevalence of hepatitis A. Some of these countries are listed at the beginning of this article, but you should consult your physician for more information.

Next, all children and adolescents 18 years of age who live in states or communities where routine vaccination has been implemented because of high disease incidences should receive the vaccine. Lastly, persons who fall within the following groups should also receive the vaccine: men who have sex with men, addicts who use street drugs, people who are treated with clotting factor concentrates and those with chronic liver disease.

There are also certain members of the population who should not receive the vaccine. First, anyone who has ever had a severe (life-threatening) allergic reaction to a previous dose of hepatitis A vaccine should not get another dose. Anyone who has a severe (life threatening) allergy to any vaccine components should not get the vaccine. Next, anyone who is moderately or severely ill at the time the shot is scheduled should probably wait until they recover. Lastly, the safety of the hepatitis A vaccine for pregnant woman has not been determined. Nevertheless, there is no evidence that it is harmful to either pregnant women or their unborn babies and the risk, if any, is thought to be very low.

It is important to note that you can only get the hepatitis A virus once and it does not lead to long-term liver problems. After it is contracted, your body builds up a defense against it. It can, as previously explained, be prevented totally if certain precautions are taken and the vaccine is received. If you meet the criteria listed above, please contact your healthcare provider to learn more.

This column is provided by the Richmond County Medical Society. Dr. Scafuri is a member of the Society, and specializes in infectious disease. He maintains a practice in West Brighton.

That's because northbound ocean currents funnel the polluted water from the Tijuana River into the Imperial Beach surf.  To say that the Mexican waters are polluted is to put it mildly.   In addition to the usual sewage and garbage debris there are all the elements of Mexico's lively drug trade, including all those used needles and broken vials. 

A 2007 survey by the nonprofit environmental group Wildcoast found that 60 percent of regular ocean users at Imperial Beach suffered from illnesses caused by water contamination.

In part of because of that study and past volunteer efforts, public health workers were on the beach Saturday offering free Hepatitis A vaccines to surfers and swimmers alike.  San Diego State University studies have shown Hepatitis A is present in 80 percent of water samples taken from the beach.

The rate of child immunizations for hepatitis A is increasing, almost doubling nationally from 26 percent in 2006 to 47 percent in 2007.

The increase was attributed to the Advisory Committee on Immunization Practices in 2006 recommending immunization for all children in the United States - not just areas with high rates of the disease - and lowering its recommended age for the shot from two years to 12 to 23 months.

Hepatitis A is a liver disease caused by ingesting even microscopic amounts of fecal matter in food or other sources.

In Illinois, the immunization rate more than tripled from 12 to 37 percent, while still lagging behind the rest of the country. 

The prestigious Johns Hopkins Bloomberg School of Public Health is out with a study that concludes that exposure to the Hepatitis E Virus (HEV) is fairly common--but disease rarely follows the exposure.

The study found antibodies indicating exposure to HEV in 21 percent of the U.S. population between 1988 and 1994. HEV is a major cause of viral hepatitis in many developing countries, but how it is spread in developed countries is not fully known. The study is published in the July 1 issue of the Journal of Infectious Diseases.

“Our study shows that animals could play an important role in the spread of HEV in the U.S. Having a dog or pet in the home or consuming meats like liver and other organs were significantly associated with increased odds of exposure to HEV,” said lead author Mark H. Kuniholm, PhD, a 2007 graduate of the Bloomberg School of Public Health.

More can be found in the School's press release or by going to the JID site.

This award, established in the memory of Maurice Hilleman, honors major contributions to pathogenesis, vaccine discovery, vaccine development, and/or control of vaccine-preventable diseases.

Dr. Hilleman is credited with developing over 40 vaccines, including those that prevent measles, mumps, rubella, Haemophilus influenzae type b, hepatitis A, hepatitis B, and chickenpox. These vaccines save millions of lives each year, and he is frequently credited with saving more lives than any other scientist of the 20th century.

Dr. Plotkin received his M.D. from the State University of New York College of Medicine, Brooklyn, and is credited with two major accomplishments. Human viruses had been attenuated by serial passage in non-human cells, a technique employed by Dr. Hilleman for the measles, mumps, and first rubella vaccines. In the 1970s, Plotkin took a strain of rubella virus from an infected fetus and attenuated it by low-temperature adaption in fetal embryo fibroblast cells. This work led to Dr. Plotkin being the first to attenuate a human virus by adaptation to low temperature and the first to make a vaccine in human cells.

Dr. Plotkin developed RA 27/3, a rubella vaccine and the first licensed vaccine made in human cells. RA 27/3 is used worldwide and as a result, the U.S., Canada, several Latin American countries, and the English speaking Caribbean Islands are free of rubella. It is expected that by 2010 the Americas will be rubella free, and by 2016, so will the European and Central Asian regions.

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.

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.

This release from a single company speaks volumes about the size of the Hepatitis A vaccine market in India, which has developed in only the last few years.  It says:

 Hard To Treat Diseases (HTDS)  says its China based operating subsidiary Mellow Hope has surpassed sales of 200,000 units of Hepatitis A Vaccine in India.

The Hepatitis A Vaccine (BIOVAC-A) was first launched in the market of India in December, 2005.

Terry Yuan, CEO added "Because our product is single-dose vaccine, so (sic) our price is almost the half of other multinational competitors' price. Our sales volume keeps growing continuously. To well promote our AV and convince the local people that our product is equal or better to our multinational competitors, we had conducted a Multi-centric clinical trial in 2007. The results proved that our product offers great safety and efficacy. Subsequently, this trial report was published in the International Journal. As a company, we hold two seminars' every year, one in India and one in China".

The company will provide further details as they become available. 

The war in Mexico between drug dealers and the government last year saw more than 5,300 killed, including 843 just across border in the 120-year old city of Tijuana. Its neighbor to the north is Imperial Beach, CA.

North and south of the Imperial Beach Pier is the Tijuana Estuary at the famed Boca Rio beachbreak. The Tijuana Sloughs is a fabled big-wave surf spot is now almost unrideable due to raw toxic sewage that flows into the break from the Tijuana River.

Now the war in Mexico is literally lapping up against Imperial Beach because so many dead bodies and dismembered bodies are being flushed into the area from the river that the danger to surfers has never been so high.

Because warning signs and health risk notices are not keeping surfers away, a nonprofit environmental group based in Imperial Group called WildCoast, is offering free Hepatitis A vaccines for surfers. In partnership with San Diego State University's Graduate School of Public Health, WildCoast is offering the vaccines at the Imperial Beach Health Center.

For more from KPBS, go here.

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.

The target audience is: Men Who Have Sex with Men, which the social health group refers to as MSMs.

We hope especially that the MSMs who work in the restaurant industry might take a look at the Hep A portion of the website because language is used to get the information across.  According to the announcement:

This new Website, which was developed with extensive feedback from MSM, offers visitors comprehensive information regarding transmission, prevention, and treatment of hepatitis A, B, and C. In addition to boosting awareness among the MSM online community about the risk factors for hepatitis, this resource seeks to increase intentions among this population to engage in safer sex practices and to receive hepatitis A and hepatitis B vaccinations. 

Visit the Website at www.ashastd.org.