Serious hepatitis A: an analysis of patients hospitalized during an urban epidemic in the United States.
BACKGROUND
Memphis and Shelby County, Tennessee, experienced an epidemic of hepatitis A in 1994 and 1995. More than 1700 cases were reported.


OBJECTIVE
To characterize the clinical features of patients hospitalized during a large urban epidemic of hepatitis A.


METHODS
Retrospective chart review.


METHODS
15 acute care hospitals in Shelby County, Tennessee.


METHODS
256 patients hospitalized with acute hepatitis A.


METHODS
Laboratory findings (such as prothrombin time and bilirubin level), complications, and mortality.


RESULTS
The median patient age was 26 years. Thirty-nine complications occurred in 35 patients. Twenty patients (8%) had extrahepatic complications, and 5 (2%) died. Patients 40 years of age and older were more likely to have serious complications, including death (P = 0.014). Sixty-seven patients (26%) presented with coagulopathy (prothrombin time > or = 3 seconds prolonged). Fifty-four patients (21%) had a bilirubin level greater than 170 micromol/L (10 mg/dL).


CONCLUSIONS
During this epidemic, hepatitis A caused serious illness and death. Complications were more frequent in patients 40 years of age and older, but young, healthy persons were also at risk for severe complications.
Willner
I R
IR
University of Tennessee, Memphis 38163, USA.
Uhl
M D
MD
Howard
S C
SC
Williams
E Q
EQ
Riely
C A
CA
Waters
B
B
D000328:Adult; D000367:Age Factors; D004196:Disease Outbreaks; D005260:Female; D006506:Hepatitis A / Q000150:complications / Q000453:epidemiology* / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013714:Tennessee / Q000453:epidemiology; D014504:Urban Health