Multiple modes of hepatitis A virus transmission among methamphetamine users.
Methamphetamine users are at increased risk of hepatitis A, but modes of transmission are unclear. The authors conducted a case-control study among methamphetamine users during an outbreak in Iowa in 1997. Twenty-eight reported, laboratory-confirmed, hepatitis A cases did not differ from 18 susceptible controls with respect to age, sex, or number of doses used. When compared with controls in multivariate analysis, case-patients were more likely to have injected methamphetamine (odds ratio (OR) = 5.5, 95% confidence interval (CI): 1.1, 27), to have used methamphetamine with another case-patient (OR = 6.2, 95% CI: 0.95, 41), and to have used brown methamphetamine (OR = 5.5, 95% CI: 0.51, 59). Receptive needle sharing was reported by 10 of the 20 case-patients who injected. Methamphetamine use with another case-patient was also associated with hepatitis A in an analysis restricted to noninjectors (OR = 17, 95% CI: 1.0, 630). During this outbreak, hepatitis A may have been transmitted from person to person among methamphetamine users through the fecal-oral and the percutaneous routes. Methamphetamine users should be vaccinated against hepatitis A and should be given immune globulin if they used methamphetamine with a case-patient in the last 2 weeks. Persons who intend to continue using methamphetamine should be advised about safer practices.
Hutin
Y J
YJ
Hepatitis Branch, Division of Viral and Rickettsial Disease, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Sabin
K M
KM
Hutwagner
L C
LC
Schaben
L
L
Shipp
G M
GM
Lord
D M
DM
Conner
J S
JS
Quinlisk
M P
MP
Shapiro
C N
CN
Bell
B P
BP
D000293:Adolescent; D019969:Amphetamine-Related Disorders / Q000150:complications*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D008297:Male; D008694:Methamphetamine; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000150:complications
D008694:Methamphetamine