2000 Indiana Report of Infectious Diseases: Hepatitis A

Hepatitis A

Rates presented are per 100,000 population and are based on the U.S. 2000 Census.

	Cases	Incidence Rate
Total	132	2.2
Race-specific cases and rates¹
White	88	1.7
Black	33	6.5
Other²	2	^*0.802
Sex-specific cases and rates
Female	42	1.4
Male	90	3.0

Hepatitis A is a viral infection most commonly transmitted by fecally contaminated food or water, or from person-to-person via fecally contaminated hands or oral-anal contact. Hepatitis A virus is found primarily in humans.

In 2000, 132 cases of hepatitis A were reported in Indiana, representing a 26% increase over the 1999. However, the incidence remained below the 1995-1999 average incidence of 228 cases (Figure HpA1). The number of reported cases was highest during the late summer and fall months (Figure HpA2).

In 2000, data indicate that blacks were 3.8 times more likely than whites to become infected with hepatitis A. Male cases (3.0 per 100,000 population) were more than twice as likely to be reported than female cases (1.4). Age-specific rates were highest among adults ages 20-29 years (3.4) followed by adults aged 30-39 years (3.1), and children ages 5-9 years old (2.9) (Figure HpA3).

Among counties with at least 5 cases reported, the incidence rates were highest in Howard (9.4 per 100,000 population), Lake (8.1) and Porter (7.5) Counties.

The most commonly reported risk factor for hepatitis A infection was contact with a known case. Approximately 29% of the interviewed cases reported prior contact with a case, most commonly through household or sexual contact. Other common risk factors included male homosexual/bisexual contact (17%) and international travel (11%). Fifteen (11%) of the interviewed cases were employed as foodhandlers during their infections. The reported risk factor data are summarized in Table HpA1.

No outbreaks of hepatitis A infection were reported in Indiana in 2000. However, in October, one case of hepatitis A was identified in a foodhandler who worked while infectious at two franchise restaurants in Marion and Johnson Counties. Over 3,000 doses of immune globulin were distributed to citizens who met the exposure criteria.

Figure HpA1: Hepatitis A Cases, Indiana, 1996-2000

Figure HpA2: Hepatitis A Cases by Month, Indiana, 2000

Figure HpA3: Hepatitis A - Incidence Rate by Age Group, Indiana, 1996-2000

Table HpA1: Hepatitis A Risk Factors, Indiana, 2000

Risk Factor		Subtotal	Number (%)*

Day-care attendee/employee			5 (4%)
Contact with day-care center attendee/employee			10 (8%)
Contact with a confirmed case			38 (29%)
	Sexual	9
	Household	20
	Other	9
Employed as a foodhandler			15 (11%)
Ate raw shellfish			3 (2%)
International travel			15 (11%)
	Mexico/Central/South America	8
	Africa	3
	Caribbean	0
	Middle East	1
	Asia	2
	Other	1
Illicit drug use			3 (2%)
	Injected	1
	Smoked	2
Male homosexual or bisexual contact			23 (17%)
More than 1 sexual partner w/in 50 days prior to illness			2 (2%)

*Percent of 132 cases who were interviewed. Multiple risk factors possible.

Footnotes

1 - Race was unknown for 132 of the reported cases.

2 - "Other" includes American Indian/Alaska Native, Asian, Native Hawaiian/Pacific Islander, and multiracial.

* - Rate based on less than 20 cases and should be considered unstable.