UMEM Educational Pearls

Category: International EM

Title: Hepatitis A Outbreak

Keywords: hepatitis A, international, food-borne illness (PubMed Search)

Posted: 6/19/2013 by Andrea Tenner, MD (Updated: 6/26/2013)
Click here to contact Andrea Tenner, MD

 

General Information:

Hepatitis A is a food-borne illness that is prevalent in developing countries.  Currently in the US we are experiencing an outbreak in 8 states related to a frozen blend of organic berries. (Linked to Townson Farms brand sold at Costco and Harris Teeter)

Clinical Presentation:

- Case definition: sudden onset of S/S + jaundice or elevated liver enzyme levels

- S/S: nausea, anorexia, fever, malaise, abdominal pain

Diagnosis:

- Hepatitis A IgM

Treatment:

- Exposed patients should be given the Hep A vaccine within 2 weeks of exposure

- Exposed patients >40 yrs old, <1 yr old, immunocompromised, or with chronic liver disease: give immunoglobulin instead (risk of more severe disease)

- Supportive care

Bottom Line:

Patients potentially exposed to Hepatitis A in the past 2 weeks should be given either the vaccination or immunoglobulin, depending on comorbid conditions.  Treatment of active infection is supportive.

University of Maryland Section of Global Emergency Health

Author: Andi Tenner, MD, MPH

References

 

http://www.cdc.gov/hepatitis/HAV/HAVfaq.htm#general

http://www.cdc.gov/hepatitis/Outbreaks/2013/A1b-03-31/index.html