Bulletin No. 24
November 25, 1988
HEPATITIS A
Statewide Outbreak Continues

Since January 1, 1988, 507 cases of hepatitis A from 60 Alaskan communities have been reported to the Section of Epidemiology. Of the 507 cases, 233 (46%) were reported from 25 villages in the Yukon-Kuskokwim (Y-K) Delta. In addition to Y-K Delta villages, cases have been documented in Anchorage (113), Peters Creek (39), Wasilla (20), Fairbanks (15), Akiachak (9), Nome (7), Palmer (7), Golovin (6), Juneau (6), North Pole (6), Dutch Harbor (5), Sitka (5), and Cordova (4). Several other villages have reported 3 or fewer cases.

Of the 507 cases, 289 (57%) were Natives, 163 (32%) were non-Natives, and 55 (11%) were of unspecified race. Cases have been reported among all age groups (Table), and 52% were males. In the 5- to 9-year-age group, there were 119 (23%) cases reported, and 254 (50%) were reported in children less than 15 years old. Of the 289 cases in Natives, 202 (70%) occurred in children less than 15 years old; in contrast, 42 (26%) of the 163 reported non-Native cases were in that age group.

Cases of hepatitis A continue to occur. In recent weeks, hepatitis A has been reported at a rate of approximately 20 cases per week (Figure). Fortunately, most cases have been mild with symptoms consisting of nausea, vomiting, loss of appetite, and occasionally jaundice.

An aggressive public health investigation of two cases in one Y-K Delta village that included serologic screening and administration of immune globulin (IG) to household contacts failed to prevent hepatitis A from spreading throughout the village's susceptible population of young children during the following 4 months. As in the 1972-77 statewide epidemic, immune globulin (IG) will not be effective in stemming this outbreak. Handwashing and careful personal hygiene are still the most important measures for controlling the transmission of hepatitis A.

Recommendations for preventing the spread of hepatitis A were published in Bulletin Number 1, week ending January 15, 1988. Copies are available from the Section of Epidemiology.

Hepatitis A In Alaska, January 1, 1983 - November 11, 1988 By Onset Date ( Report date used in absence of onset date ) n = 959

# o f C a s e s	120
	110
	100
	90
	80
	70
	60
	50
	40
	30
	20
	10
		J			A			J			O			J			A			J			O			J			A			J			O			J			A			J			O			J			A			J			O			J			A			J			O
		1983												1984												1985												1986												1987												1988

Hepatitis A in Alaska January 1 - November 11, 1988 N = 507
Age Group	Male	Female	Total
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 >50	24 62 43 20 15 32 26 19 9 0 12	27 57 41 11 23 27 25 9 10 2 13	51 119 84 31 38 59 51 28 19 2 25
Total	262	245	507

All suspected or diagnosed cases of hepatitis A should be reported immediately to the Section of Epidemiology (561-4406), or through the Rapid Telephonic Reporting System (800-478-1700).

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