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Will Hepatitis A Become a Vaccine-Preventable Disease?

Harold S. Margolis, MD; and Miriam J. Alter, PhD
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Centers for Disease Control and Prevention, Atlanta, GA 30333 Requests for Reprints: Harold S. Margolis, MD, Hepatitis Branch (A-33), Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1995;122(6):464-465. doi:10.7326/0003-4819-122-6-199503150-00011
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Fifty years ago, hepatitis A was a common disease worldwide and most people had been infected with the hepatitis A virus (HAV) by the time they were young adults. Now, patterns of HAV transmission differ markedly among geographic regions throughout the world. In developing countries, most of the population is infected before 10 years of age, and HAV is the most frequent cause of acute hepatitis in children [1]. Most children less than 5 years of age do not have clinically evident infection, but they efficiently transmit HAV to their contacts in the household and in the community [2]. In more developed countries, the risk for infection is lower and most infections occur in older children and adults [1]. In many countries, changes in sanitation and socioeconomic level appear to have reduced the likelihood of infection with this enterically transmitted virus [1, 3]. Person-to-person contact is the primary mode of transmission, and food and water are infrequently implicated, although a massive outbreak of hepatitis A occurred in China when a susceptible young adult population consumed raw shellfish harvested from virus-contaminated waters [46].

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