A Community-wide epidemic of hepatitis A in Ohio.
Between June 1, 1983 and August 30, 1984, an epidemic involving 313 cases of hepatitis A occurred in Muskingum County, Ohio. One hundred ninety-seven cases occurred in the city of Zanesville, with 34.7% of cases concentrated in two neighborhoods in the eastern part of the city. Case characteristics were similar to those reported in previous community-wide outbreaks, including a maximum attack rate among 5-9-year-olds and a very low attack rate in adults over 30 years. Case households were larger, and their members were less educated than the mean for households in the city. Forty-eight per cent of the cases reported exposures to other cases which temporally could have been the source of infection. A case-control study failed to show differences in several behavioral factors between case and control households, but did confirm that lower socioeconomic status was a risk factor for the disease. Broad use of immunoglobulin was effective in preventing clinical disease among family contacts, but did not stop the outbreak. This outbreak typifies a genre of hepatitis A epidemic transmitted from person to person in which exact routes of spread are poorly understood and control is difficult. Lower socioeconomic status may be a marker for some unidentified behaviors that promote hepatitis A transmission.
Shaw
F E
FE
Sudman
J H
JH
Smith
S M
SM
Williams
D L
DL
Kapell
L A
LA
Hadler
S C
SC
Halpin
T J
TJ
Maynard
J E
JE
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks / Q000453:epidemiology*; D004812:Epidemiologic Methods; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology; D007223:Infant; D008297:Male; D008875:Middle Aged; D009820:Ohio; D012306:Risk; D012737:Sex Factors; D012959:Socioeconomic Factors
D007075:Immunoglobulin M