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Transmission of Hepatitis Viruses

Craig N. Shapiro, MD
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Centers for Disease Control and Prevention, Atlanta, GA 30333. Requests for Reprints: Craig N. Shapiro, MD, Hepatitis Branch, MS G-37, Centers for Disease Control and Prevention, Atlanta, GA 30333.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1994;120(1):82-84. doi:10.7326/0003-4819-120-1-199401010-00014
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Hepatitis A virus (HAV) is shed in the feces, and peak titers occur during the 2 weeks before and 1 week after onset of illness [1]. Virus is also present in serum and saliva during this period, although in concentrations several orders of magnitude less [2]. Consequently, the most common mode of transmission is fecal-oral, with the virus being transmitted from person to person or by contaminated food or water [3]. On the basis of cases of hepatitis A reported in 1992 to the Centers for Disease Control and Prevention (CDC), the most frequently reported risk factor was household or sexual contact with a person with hepatitis (24%), followed by day-care attendance or employment (15%), recent international travel (6%), and association with a suspected food- or water-borne outbreak (5%). Many persons with hepatitis A do not identify risk factors; their source of infection may be other infected persons who are asymptomatic.

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