Are we at risk of hepatitis A epidemic? According to specialists in Poland, we can already speak of an epidemic of hepatitis A (food jaundice). In 2016, only 35 cases of this disease were recorded. Until the end of September 2022, as many as 1,685 people became ill with hepatitis A across the country and the number of infected people increases week by week. Fortunately, the spread of the epidemic can be prevented.
Are we at risk ofhepatitis A epidemic ? According to specialists in Poland, we can already speak of an epidemic of hepatitis A (food jaundice). In the previous years, the number of cases was relatively low. In 2016, only 35 cases of this disease were recorded. From the beginning of 2022 to the end of November, over 2,600 cases of hepatitis A were registered across the country. The worst situation is in Silesia, where 438 cases of this disease were recorded by November 30, informs Dziennik Zachodni. For comparison, in 2016 in Silesia there were 3 cases, and the year before 7. The most cases of the disease were recorded in Sosnowiec (as many as 196 patients).
Sanepid discovered that sick people worked in shops, bars and restaurants where they were involved in the production and distribution of food, and that hepatitis A is the so-called dirty hands disease. It is transmitted mainly through the food, through food or water. There is also the possibility of getting infected through close contact, including sexual intercourse. The disease is acute, it damages the liver. The first symptoms resemble the flu - there is a general breakdown, chills, low-grade fever. Only then does jaundice appear.
Hepatitis A (hepatitis A, food jaundice)
Over the years, there has been a clear decrease in hepatitis A cases, mainly as a result of improved sanitary conditions and hygiene of the society (better clean drinking water, modern sewage and wastewater treatment systems, food contamination control, lower population density, etc. ). However, every 8-20 years there are still so-called compensatory epidemics (local - schools, nurseries, kindergartens, cities, regions) around the world. This is associated with the expiration of herd immunity and an increasing percentage of people susceptible to infection, which, under favorable circumstances, maycause an epidemic .¹ Then the incidence is very high and often exceeds 700/100 thousand². The last compensatory epidemic in Poland took place in 1996 with the largest number of cases in the coastal zone .¹ From then until 2022, the entire country was recorded at most several dozen cases of the disease per year.
Read more: 110-fold increase in the incidence of hepatitis A
The hepatitis A epidemic - who is most at risk?
The risk groups for HAV infection include:
- traveling from low endemic countries to hyperendemic areas (Middle and Far East)
- people in barracks - army, police
- medical staff
- patients with hemophilia and other hereditary clotting factor deficiencies
- people working in the production and distribution of food
- people with chronic liver diseases, especially hepatitis B and C
- children gathered in nurseries
- drug addicts
- men having sexual contact with men
- workers of sewage, water supply, city cleaning
It is worth knowing that HAV infection in most children - unlike adults - is asymptomatic or mildly symptomatic, therefore they are an important source of infection and play a fundamental role in the spread of this virus. The highest incidence of hepatitis A (hepatitis A) is at the age of 5-14 (Fig. 1) - almost 1/3 of all cases occur in children up to the age of 15.
Hepatitis A epidemic - the most important hand washing
The virus spreads through particles of stool or mucus, so remember about personal hygiene. Washing your hands will flush the virus and get rid of it largely from your hands.
ImportantTransmission of the HAV virus occurs through the ingestion or by dirty hands, most often between people who are in close contact with each other. The virus can be found on food.
The best way to avoid complications of hepatitis A and compensatory epidemics, apart from non-specific prophylaxis (personal hygiene), is protective vaccinations, recommended especially in people with high-risk flu .³
HCV A epidemic - vaccine may prevent it
Since 1995, extinction of the epidemic and elimination of the disease has been possible through the use of a vaccine against hepatitis A. Clinical evidence of the effectiveness of the vaccine against hepatitis A has been presented, supported by laboratory tests. The anti-HAV vaccine stimulates the gradual growth of antibodies.
Vaccination against hepatitis A, if it covers 80% the exposed population eliminates the fireinfection within a maximum of 6 weeks, which leads to a complete extinction of the epidemic .²
After 2 weeks, they reach protective values, which then last for many years, possibly for life.
Due to the high incidence rate and fundamental importance in the spread of HAV infection, the immunization program should primarily include children. Routine vaccination of children against hepatitis A will allow:
- reduce the number of cases in the group with the highest incidence rate
- eliminate the primary source of infection for older children and some adults
- in the future, when vaccinated children reach adulthood, also prevent infections in adults as vaccination provides long-term immunity
However, vaccines against hepatitis A are available, but they are not included in the vaccination schedule, are not compulsory, and therefore are not free. Preparations given in two doses, 6 months apart, are to ensure immunity to the disease.
Worth knowingVaccinations against hepatitis A are highly effective in reducing the epidemic, but the following conditions should be met:
- they should be carried out at the beginning of the epidemic
- should cover the largest possible proportion of the exposed population
- should cover all age groups, with particular preference for children and adolescents
Rapid increase in the incidence of hepatitis A. It's already an epidemic
In the previous years, the number of cases was relatively low. In 2016, only 35 cases of this disease were recorded. Only by the end of September 2022, as many as 1,685 people fell ill with hepatitis A across the country. And - as Gazeta Wyborcza writes - the number of infected people increases from week to week. There are no more places in infectious wards in Silesia, the Sanepid warns against the lack of vaccines. - Compared to the median from 2009-2016, we have a 32-fold increase - explains "GW" Dr. Iwona Paradowska-Stankiewicz, head of the Epidemiological Department at the National Institute of Hygiene.
Source: "Gazeta Wyborcza"
1. Wawrzynowicz-Syczewska M., Hepatitis A [in:] Infectious and parasitic diseases 2nd edition
2. Miksa G., Mrozińska M., Hepatitis A - a modern, effective, safe method of fighting hepatitis A epidemics, "Doctor's Guide" 2002
3. Hepatitis A virus (HAV), www.prometeusze.pl/hav.php