Epidemiology and Prevention of Viral Hepatitis A to E:

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Viral Hepatitis - Overview

Type of Hepatitis
A
B
C
D
E
Source of
feces
blood/
blood/
blood/
feces
virus
blood-derived
blood-derived
blood-derived
body fluids
body fluids
body fluids
Route of
fecal-oral
percutaneous
percutaneous
percutaneous
fecal-oral
transmission
permucosal
permucosal
permucosal
Chronic
no
yes
yes
yes
no
infection
Prevention
pre/post-
pre/post-
blood donor
pre/post-
ensure safe
exposure
exposure
screening
exposure
drinking
immunization
immunization
risk behavior
immunization
water
modification
risk behavior
modification
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Estimates of Acute and Chronic DiseaseBurden for
Viral Hepatitis, United States
HAV
HBV
HCV
HDV
Acute infections
(x 1000)/year
125-200
140-320
35-180
6-13
Fulminant
deaths/year
100
150
?
35
Chronic
0
1-1.25
3.5
infections
million
million
70,000
Chronic liver disease
deaths/year
0
5,000
8-10,000
1,000
Range based on estimated annual incidence,
1984-1994.
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Hepatitis A Virus
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Hepatitis B Virus
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Geographic Distribution of HAV Infection
Anti-HAV Prevalence
High
Intermediate
Low
Very Low
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Geographic Distribution of Chronic HBV Infection
HBsAg Prevalence
³8 - High
2-7 - Intermediate
lt2 - Low
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Acute Viral Hepatitis by Type, United States,
1982-1993
34
47
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Hepatitis A
Hepatitis B
Hepatitis C
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Hepatitis Non-ABC
Source CDC Sentinel Counties Study on Viral
Hepatitis
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Non viral hepatitis

• Amebic dysentery
• Cirrhosis of the liver,
• Mononucleosis
• Toxic hepatitis
• alcohol, carbon tetrachloride, some tranquilizers
  and antibiotics, and many other substances.

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Hepatitis B Virus
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Outcome of Hepatitis B Virus Infection by Age at
Infection
100
100
80
80
60
60
Chronic Infection
Chronic Infection ()
40
40
20
20
Symptomatic Infection ()
Symptomatic Infection
0
0
1-6 months
7-12 months
Older Children and Adults
Birth
1-4 years
Age at Infection