Ira R. Willner, MD; Mark D. Uhl, MD; Scott C. Howard, MD; Ernest Q. Williams, MD; Caroline A. Riely, MD; Bradford Waters, MD
Memphis and Shelby County, Tennessee, experienced an epidemic of hepatitis A in 1994 and 1995. More than 1700 cases were reported.
To characterize the clinical features of patients hospitalized during a large urban epidemic of hepatitis A.
Retrospective chart review.
15 acute care hospitals in Shelby County, Tennessee.
256 patients hospitalized with acute hepatitis A.
Laboratory findings (such as prothrombin time and bilirubin level), complications, and mortality.
The median patient age was 26 years. Thirty-nine complications occurred in 35 patients. Twenty patients (8%) had extrahepatic complications, and 5 (2%) died. Patients 40 years of age and older were more likely to have serious complications, including death (P = 0.014). Sixty-seven patients (26%) presented with coagulopathy (prothrombin time ≥ 3 seconds prolonged). Fifty-four patients (21%) had a bilirubin level greater than 170 µmol/L (10 mg/dL).
During this epidemic, hepatitis A caused serious illness and death. Complications were more frequent in patients 40 years of age and older, but young, healthy persons were also at risk for severe complications.
Willner IR, Uhl MD, Howard SC, Williams EQ, Riely CA, Waters B. Serious Hepatitis A: An Analysis of Patients Hospitalized during an Urban Epidemic in the United States. Ann Intern Med. ;128:111–114. doi: 10.7326/0003-4819-128-2-199801150-00006
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Published: Ann Intern Med. 1998;128(2):111-114.
Gastroenterology/Hepatology, Infectious Disease, Liver Disease.
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