title: Community-wide outbreak of hepatitis A among an Indian population in Oklahoma.
abstract: Between September 1983 and September 1984, 118 cases of hepatitis A were reported from Caddo County, Oklahoma. No common source was identified, and the epidemic curve suggested person-to-person transmission. In July 1984, enhanced control measures were implemented; these consisted of improvements in surveillance, standardization of case investigation, an expanded, although targeted, use of immune globulin, and a public awareness campaign. Control measures resulted in a decrease in the delay between onset of symptoms and case report (from 12 days to 4 days), an increase in the percentage of patients with confirmed cases interviewed (from 77% to 100%), an increase in the percentage of patients reporting contact with a previous case (from 39% to 72%), and an increase in the average number of household-like contacts per case (from seven to 27). Within two incubation periods of the implementation of enhanced controls, the outbreak ended. These data indicate that community-wide outbreaks of hepatitis A can be stopped with an intensive epidemiologic approach, coupled with the expanded and targeted use of immune globulin.
authors.affiliation: Comanche County Health Department, Lawton, Okla.
authors.forename: B
authors.initials: B
authors.lastname: Gildon
authors.forename: S
authors.initials: S
authors.lastname: Makintubee
authors.forename: G R
authors.initials: GR
authors.lastname: Istre
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D006266:Health Education; D006506:Hepatitis A / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy / Q000635:transmission; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007198:Indians, North American; D007223:Infant; D007231:Infant, Newborn; D009825:Oklahoma
chemical_list: D016756:Immunoglobulins, Intravenous