A Podful of Pediatrics

The One Where We Talk About Hep A and Community Immunity

Episode Summary

Hepatitis A is a contagious liver infection that spreads easily, especially in childcare settings. In young children it is often mild, but in older kids and adults it can lead to hospitalization and serious complications. In this episode we explain Hepatitis A symptoms, how it spreads, and how the two dose vaccine changed infection rates in the United States. We also break down community immunity and why declining vaccination rates are contributing to measles outbreaks and a severe flu season. You will learn who is most at risk, when antivirals like Tamiflu are recommended, and what practical steps families can take to protect their children. Guidance referenced from the American Academy of Pediatrics and global data from the World Health Organization

Episode Notes

  1. Division of Viral Hepatitis. Hepatitis Surveillance Report - United States, 2011. United States Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA 2011. 
  2. Daniels D, Grytdal S, Wasley A, Centers for Disease Control and Prevention (CDC). Surveillance for acute viral hepatitis - United States, 2007. MMWR Surveill Summ 2009; 58:1.
  3. Hadler SC, Webster HM, Erben JJ, et al. Hepatitis A in day-care centers. A community-wide assessment. N Engl J Med 1980; 302:1222.
  4. Vernon AA, Schable C, Francis D. A large outbreak of hepatitis A in a day-care center: association with non-toilet-trained children and persistence of IgM antibody to hepatitis A virus. Am J Epidemiol 1982; 115:325.
  5. Tong MJ, el-Farra NS, Grew MI. Clinical manifestations of hepatitis A: recent experience in a community teaching hospital. J Infect Dis 1995; 171 Suppl 1:S15.
  6. Centers for Disease Control and Prevention. Hepatitis Surveillance Report. United States Department of Health and Human Services, Centers for Disease Control and Prevention, Atlanta, GA 2011. 
  7. 7.World Health Organization . Hepatitis A - fact sheet 2019. 2019. [accessed 2019 December20]. https://www.who.int/news-room/fact-sheets/detail/hepatitis-a. 
  8. 8.World Health Organization . Global health sector strategy on viral hepatitis, 2016–2021 Geneva: World Health Organization; 2016. June [accessed 2019 December20]. http://apps.who.int/iris/bitstream/10665/246177/1/WHO-HIV-2016.06-eng.pdf?ua=1. 
  9. Link-Gelles R, Hofmeister MG, Nelson NP. Use of hepatitis A vaccine for post-exposure prophylaxis in individuals over 40 years of age: A systematic review of published studies and recommendations for vaccine use. Vaccine. 2018;36(20):2745–50.doi: 10.1016/j.vaccine.2018.04.015. 
  10. .Dhankhar P, Nwankwo C, Pillsbury M, Lauschke A, Goveia MG, Acosta CJ, Elbasha EH. Public health impact and cost-effectiveness of hepatitis A vaccination in the United States: a disease transmission dynamic modeling approach. Value Health. 2015;18(4):358–67. doi: 10.1016/j.jval.2015.02.004. 
  11. https://my.clevelandclinic.org/health/articles/22599-herd-immunity?utm_source=join1440&utm_medium=email&utm_placement=newsletter&user_id=66c4bce35d78644b3a99e621
  12. https://onech-my.sharepoint.com/:w:/r/personal/smithj_onecommunityhealth_org/_layouts/15/Doc.aspx?sourcedoc=%7B25810DE8-2910-43D0-9634-B1DDDD87FA61%7D&file=Podcast%2024%20Hepatitis%20A.docx&fromShare=true&action=default&mobileredirect=true
  13. https://onech-my.sharepoint.com/:w:/r/personal/smithj_onecommunityhealth_org/_layouts/15/Doc.aspx?sourcedoc=%7B25810DE8-2910-43D0-9634-B1DDDD87FA61%7D&file=Podcast%2024%20Hepatitis%20A.docx&fromShare=true&action=default&mobileredirect=true
  14. https://onech-my.sharepoint.com/:w:/r/personal/smithj_onecommunityhealth_org/_layouts/15/Doc.aspx?sourcedoc=%7B25810DE8-2910-43D0-9634-B1DDDD87FA61%7D&file=Podcast%2024%20Hepatitis%20A.docx&fromShare=true&action=default&mobileredirect=true

        15.  www.boostoregon.org