American Journal of Epidemiology Vol. 122, No. 2: 226-233
Copyright © 1985 by The Johns Hopkins University School of Hygiene and Public Health
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FREQUENCY OF ILLNESS ASSOCIATED WITH EPIDEMIC HEPATITIS A VIRUS INFECTIONS IN ADULTS
1Division of Preventive Medicine, Walter Reed Army Institute of Research Washington, DC
2Division of Infectious Diseases, University of North Carolina School of Medicine Chapel Hill, NC
3Preventive Medicine Consultants Division, Office of the US Army Surgeon General Washington, DC
4Department of Virus Diseases, Walter Reed Army Institute of Research Washington, DC
5Preventive Medicine Service, US Army MED-DAC Fort Wainwright, AK
Reprint requests to Dr. Wayne M. Lednar at current address: Preventive Medicine Service, Madigan Army Medical Center, Tacoma, WA 98431
Hepatitis A virus infection is often described as mild or asymptomatic, particularly in children. The failure of most adults who are found to be immune to remember symptoms of an illness suggestive of hepatitis A virus supports this belief. In 1982, two large outbreaks occurred in well documented populations of military personnel. These outbreaks were each extensively studied epldemiologically and serologically. It was found that 28/29 (96.6%) hepatitis A infections recognized prior to immune serum globulin in Outbreak A and 35/46 (76.1%) infections in Outbreak B were symptomatic. Symptomatic cases failed to occur beyond eight days of immune serum globulin administration to these predominantly susceptible groups. Between 40 and 70% of patients were icteric. Apparent contrasts in symptoms associated with hepatitis A infection in adults and children suggest a basic age-dependent difference in immune response to such infection.
age factors; disease outbreaks; hepatitis A virus; immunization; military personnel
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