Viral Hepatitis A, 2002
In 2002, 53 cases of hepatitis A (1.1 per 100,000 population) were reported. Thirty-nine (74%) case-patients were residents of the seven-county Twin Cities metropolitan area, 30 (77%) of whom resided in Hennepin or Ramsey Counties. Thirty-five (66%) of the case-patients were male. Of 49 cases for whom race was reported, 37 (76%) were white, five (10%) were black, three (6%) were Asian, and two (4%) were American Indian. Although the greatest number of case-patients were white, incidence rates were higher among American Indians (2.5 per 100,000), blacks (2.5 per 100,000), and Asians (1.8 per 100,000) than among whites (0.8 per 100,000).
Hispanic ethnicity was reported for two cases (1.4 per 100,000). Casepatients ranged in age from 1 to 89 years; 16 (30%) cases occurred among adults 25 to 44 years of age.
Two (4%) case-patients were employees of a food-service establishment in Goodhue County. Immune globulin prophylaxis and hepatitis A vaccine consequently were recommended for 23 exposed individuals, three of whom were fellow food-handlers.
Of the remaining 51 sporadic cases of hepatitis A reported in 2002, a risk factor for infection was identified for 41 (80%). Ten (20%) cases were associated with travel, five (50%) of which involved travel to South America or Mexico. Eight (16%) case-patients had known contact with another case, nine (18%) were men who had sex with men, and three (6%) had consumed raw shellfish. Overall, seven (14%) cases (all adults) were associated with childcare settings but were not related to any known outbreaks. Two of those seven cases had additional risk factors. Young children infected with hepatitis A virus often are asymptomatic or experience mild illness but remain efficient transmitters of disease. Persons who travel to countries where hepatitis A is endemic and men who have sex with men should be educated about their risk of hepatitis A and offered hepatitis A vaccine.