Hepatitis A

1
Hepatitis A
2
Step 2 Establish existence of an outbreak

• Contacts
• 1st case- 2 contacts
• 2nd case- 3 contacts
• 3rd case- Sexual contacts
• 3 current boyfriends fmr.boyfriend
• - Household contacts
• Son
• Mother Father
• A Gentleman and Lady 2 Kids
• Sister Boyfriend 2 Kids
• 1 Contact

3
4/30/03
Mother 2/21
Child 2/21
StepFather
S 1/15
Girlfriend Sister
T 2/13
Mother
Girlfriend Sister Boyfriend
M 3/25
Hepatitis A Outbreak
Fmr.Boyfriend
Boyfriend
M -
J 3/21
F -
Boyfriend
Sisters Boyfriend
Boyfriend
Sister
Contact
IG Given
Child
IgM
C
Child
GS JW
J
Household contact
Child
4
Step 3 Verify Diagnosis

• 8 individuals with HAV-IgM
• All 8 showed signs and symptoms (i.e. jaundice)

5
Step 4 Define Identify Cases

• Clinical case definition
• Discrete onset of symptoms and
• Jaundice or elevated serum aminotransferase
  levels
• Laboratory criteria
• Immunoglobulin M (IgM) antibody to hepatitis A
  (anti-HAV) positive

6
Step 4 Define Identify Cases

• Confirmed Case A case that meets the clinical
  case definition and is laboratory confirmed or
  for hepatitis A, a case that meets the clinical
  case definition and occurs in a person who has an
  epidemiological link with a person who has
  laboratory-confirmed hepatitis A (i.e. household
  or sexual contact with an infected person during
  the 15-50 days before onset of symptoms)
• 8 Cases of acute hepatitis A

7
Step 5 Perform Descriptive Epidemiology
8
Step 6 Develop Hypotheses

• M was the index case
• Did not seek medical care or treatment
• S wanted to hide his sexual preference and did
  not expose M
• Positive individuals did not reveal contacts to
  LHD thus number of cases increased

9
Step 9 Implement Control/Preventive Measures

• Letter was sent to students of school
• Prevention messages
• Always wash your hands after using the bathroom.
• Always wash your hands after cleaning the toilet.
• Always wash your hands after changing diapers.
• Always wash your hands after handling soiled
  towels or linens.
• Always wash your hands before fixing food or
  eating.
• If exposed to hepatitis A, ask your doctor about
  immune globulin.