Central District Health Urges Health Care Providers to Continue to Watch for Hepatitis A and Vaccinate Those at Risk

Hepatitis A continues to be of concern in our region with eight cases being diagnosed among Ada and Elmore county residents this year, and an additional seven throughout the state. Providers should continue to test patients with clinically compatible signs and symptoms and vaccinate susceptible adults and children.

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.

Prevention
Pre-exposure vaccination is the best protection against hepatitis A. The hepatitis A vaccine is routinely recommended for children. It is recommended for adults wishing to obtain immunity or who are at higher risk for infection or severe disease. Adults in the high-risk group include:

• Persons experiencing homelessness
• Users of injection and non-injection drugs
• Men who have sex with men
• Persons with chronic liver disease
• Persons traveling to countries with moderate to high hepatitis A endemicity
• Others including persons having close contact with a newly arriving international adoptee, persons with clotting factor disorders, and persons who work with hepatitis A in a laboratory setting.

In order to help prevent further spread, CDHD recommends providing vaccine routinely to patients in the above high risk groups.

CDHD is currently offering vaccine, at no cost to the patient (insurance may be billed), to people who are experiencing homelessness, users of injection or non-injection drugs, men who have sex with men, and people who are uninsured or underinsured. Patients
may call 208-327-7400 to make an appointment

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.

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