Published On: Wed, Jun 19th, 2013

The multistate hepatitis A outbreak has a hospitalization rate of 47%: Is this unusually high?

According to the latest hepatitis A outbreak linked to Townsend Farms Organic Anti-Oxidant Blend update from the Centers for Disease Control and Prevention (CDC) on June 19 says the total number of cases from eight states is 118.

Hepatitis A Image/CDC

Hepatitis A

One interesting note concerning this outbreak is the number of hospitalizations. As of June 18, 2013, the CDC completed epidemiologic investigations on 116 of the 118 total cases.

54 cases, or 47% of  ill people have been hospitalized, and no deaths have been reported.

Is this hospitalization rate high for a virus like hepatitis A? I am not the only one who made this observation.

A moderator for the infectious disease/outbreak monitoring website, ProMED-mail – the Program for Monitoring Emerging Diseases said something similar on June 18–“The high proportion of hospitalisations is noteworthy; however, and perhaps other contaminants have played a role.”

I asked Professor of Microbiology & Immunology in the College of Physicians and Surgeons of Columbia University, Vincent Racaniello Ph.D. was his thoughts were on the hospitalization rate.

Dr. Racaniello told The Global Dispatch via email, “I don’t see any reason to suppose that this outbreak is any more virulent than others. During the Pennsylvania HAV outbreak associated with green onions the hospitalization rate was 26%.”

He adds, according the Fields Virology (sixth edition):

“Of those with overt hepatitis A, from 21% to 53% are hospitalized, with the lowest being among children and the highest among persons 60 years of age or older.

“It might be interesting to know the age breakdown in this outbreak to see if it is skewed toward older people.

“I think the numbers in the current outbreak are much too preliminary to make any conclusions. I think case ascertainment bias likely explains the higher number in the current berry outbreak.

“In other words,  less ill individuals have not sought medical attention, or been properly diagnosed by physicians. The berry outbreak is likely much larger than is currently known which would push down the % hospitalization.”

The age breakdown data is not available in the CDC outbreak update, only saying that “Ages range from 2 – 87 years”.

I guess we’ll have to let this outbreak play out before my question can be answered.

Hepatitis A is a viral infection of the liver. Symptoms may include fever, fatigue, loss of appetite, nausea, vomiting and abdominal discomfort. Jaundice, a yellowing of the skin and eyes, may occur a few days after symptoms appear. Anyone with these symptoms should contact a health care provider. The incubation period, or time between exposure and symptoms, is typically 28 days. It is possible for hepatitis A to be active but not show symptoms for up to 7 days. Symptoms usually last one to two weeks but can last longer. Young children with hepatitis A often have no symptoms.

Hepatitis A is spread person-to-person and through a fecal-oral transmission route, and typically occurs when a person eats food or drinks a beverage contaminated by someone with the virus. The virus is not spread by coughing, sneezing or by casual contact. Severe complications from hepatitis A are rare and occur more often in people who have liver disease or a weakened immune system.

Thorough hand washing after visits to the restroom, before touching food or drink and after changing a diaper are the best way to control the spread of hepatitis A.

For more information on Hepatitis A, see the CDC’s page “Hepatitis A Information for the Public”.


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About the Author

- Writer, Co-Founder and Executive Editor of The Global Dispatch. Robert has been covering news in the areas of health, world news and politics for a variety of online news sources. He is also the Editor-in-Chief of the website, Outbreak News Today and hosts the podcast, Outbreak News Interviews on iTunes, Stitcher and Spotify Robert is politically Independent and a born again Christian Follow @bactiman63

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  1. CDC revises reporting criteria for hepatitis A outbreak: Only confirmed cases - The Global Dispatch says:

    […] June 19, The Global Dispatch asked the question concerning the percentage of people requiring hospitalization–Is this unusually […]

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