Hepatitis A Outbreak: A Vaccine For That

The CDC declared an outbreak of Hepatitis A over the weekend that has affected over 30 people in 5 states. Preliminary information confirms the source of the outbreak stems from organic frozen berries that were sold at Costco stores (including stores in Washington) yet sickened people thus far are in Colorado, New Mexico, Arizona, Nevada, and California. No cases have been reported in Washington to date. The berries: Townsend Farms Organic Anti-Oxidant Blend, a frozen berry and pomegranate seed mix, have now been pulled from shelves and people who purchased these berries from February through May are being contacted.
The amazing thing about this outbreak: there’s been no reported cases of Hep A in children under age 18.
In the United States, Hepatitis A typically spreads through contaminated food handled by someone with the infection. Rates of Hepatitis A infection tops 5,000-10,000 cases annually in the US while they are far higher in the developing world because city water sources can get contaminated (see below). Hepatitis A vaccine is recommended before international travel.
The lack of children with infections from this outbreak is logical and potentially illustrative.

Thing is, there’s a vaccine that provides longterm immunity against Hepatitis A. We now immunize all children against Hep A after their 1st birthday. We started immunizing all children after 2006 against Hepatitis A. Prior to that, children living in communities with high rates of Hepatitis A infection received the shots.
If you or your children may have been exposed to these berries in the last 2 weeks, it is recommended you get the Hep A immunization now to potentially prevent infection.
Hepatitis A is spread through contaminated food. Hepatitis A symptoms tend to be more mild in children when compared to adults. However, Hepatitis A is a hepatitis–meaning the viral infection causes inflammation of the liver. When infected with hepatitis A children can have jaundice (yellowing of the skin and eyes), vomiting, diarrhea, and nausea. Rarely the infection can cause hospitalization. However I vividly remember admitting a child with Hepatitis A to the hospital while a resident physician. She was sick, vomiting, and bright yellow…
If you want to protect yourself from Hepatitis A, the best thing to do is be vaccinated. Fortunately, children are far better protected during these outbreak as we immunize all children in the United States. At the next check-up ensure your children are up to date, especially if born before 2006 as the Hep A 1 year-old shot wasn’t routine prior to that.

The Kids Are Lucky, The Hepatitis A Shot

• Hepatitis A vaccine is given to all children starting at 1 year of age. We give the first dose at the 12 month-old well child appointment and the second dose at 18 months of age. Children need 6 months between the two doses. Over 95% of children immunized are protected against getting Hepatitis A infection.
• All children are recommended to get catch-up doses of Hep A vaccine if they haven’t had it. Prior to 2006, children only received Hepatitis A vaccine if living in a city or county with higher rates of infection. If your child was born before 2006, ensure they have received the catch-up of this 2-shot series throughout the last few years.
• Hepatitis A vaccine is a very successful vaccine with few serious side effects. Pain at the injection site is the most common side effect followed by headache in 5-10% of people. The benefit of Hepatitis A vaccinations far outweighs the small risks of the shot. The vaccine has been given to millions of people without serious side effects.
• Consider Hepatitis A if you’re traveling to Asia, Central or South America, the Mediterranean Basin, Southern Europe, the Middle East, Mexico, and the Caribbean. It’s recommended every traveler get Hepatitis A vaccine 1 month prior to international travel. But even if just two weeks prior to your trip, go get Hep A vaccine if you haven’t. Evidence finds that immunity (as measured by antibodies in your blood) can rise days after the first vaccination against Hep A and may protect you on a trip in the upcoming two weeks. If you’re traveling in the next couple weeks, call a travel clinic as there are other ways to protect yourself against Hepatitis A infection during travel via immune globulins.
• The CHOP Vaccine Education Center explains travel risk: “Because hepatitis A virus is present in the stools of people who are infected, countries or cities with low standards for the handling and disposal of sewage have an enormous problem with hepatitis A virus infections. The problem is that the virus quickly enters the water supply and contaminates anything that comes in contact with the water. It is probably not unrealistic to think about many developing countries as having a thin layer of hepatitis A virus that covers anything that you could put into your mouth.” YUCK!

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