DATE: Thursday, May 1, 1997 TAG: 9705010496 SECTION: LOCAL PAGE: B1 EDITION: FINAL SOURCE: BY DEBRA GORDON, STAFF WRITER DATELINE: NORFOLK LENGTH: 92 lines
Got a kid in day care? Then you are at risk for contracting hepatitis A.
In fact, you have a greater chance of getting the infectious liver disease from your toddler than from any contaminated food, even from fruit like the frozen strawberries that infected more than 150 Michigan children and teachers last month.
That's because the hepatitis A virus is transmitted through human waste, or, in the case of day-care centers, the ever-present dirty diaper.
A new study shows that the hepatitis A vaccine, approved only for children beginning at 2 years of age, is safe for use in younger children.
The study, conducted on 53 infants aged 2 months to 15 months, is one of two recently completed in the United States that shows the vaccine can be used in infants. The study was conducted at two medical schools in Texas and at Norfolk's Center for Pediatric Research, a joint program between Children's Hospital of The King's Daughters and Eastern Virginia Medical School.
Researchers, including the pediatric center's director, Dr. Larry Pickering, vaccinated each of the infants three times and evaluated the vaccine's side effects and the protection it provided. The most common reaction was soreness at the injection site.
The virus successfully triggered the production of hepatitis A antibodies in the children, Pickering reports in a paper accepted for publication in the medical journal ``Vaccine.'' Antibodies are blood proteins created when a person is exposed to a virus; they provide immunity against future exposure to that virus.
More testing is required before the Food and Drug Administration approves the vaccine's use for younger children, Pickering said. He expects FDA approval within the next few years.
When that happens, Pickering says all children should get the hepatitis A vaccine, just as they currently get shots for other viruses such as diphtheria, measles and tetanus. And, as a member of the American Academy of Pediatrics' Infectious Disease Committee, which recommends the vaccines this country's children routinely receive, he's in a position to make it happen.
``We're going to keep having outbreaks,'' he said, referring to the early April eruption caused by a batch of tainted frozen strawberries.
About a third of all Americans are infected with hepatitis A at some point in their lives, between 125,000 and 200,000 a year. Of those, between 84,000 and 134,000 actually get sick, according to the Centers for Disease Control and Prevention in Atlanta.
Symptoms resemble a severe case of the flu, including severe diarrhea, nausea, fatigue and loss of appetite. The illness might last as long as a month, and some adults take up to a year for a full recovery.
But children under 5 - who are often the carriers of disease - rarely show any symptoms. Routinely immunizing young children would make them resistant to the disease and prevent them from carrying it home to their parents, Pickering said.
Children 2 and older could get the immunizations now, Pickering said, but because the vaccine, which costs about $40 a dose, is not on the ``recommended'' list of immunizations, insurance rarely pays for it.
He expects his committee will eventually recommend the vaccine's inclusion on the approved list, particularly as part of a ``super-vaccine'' currently under development, which combines nearly all the routine immunizations children need into one shot. ILLUSTRATION: VACCINE
Currently: The hepatitis A vaccine is only approved for children 2
and older.
What's next: More testing is required before the Food and Drug
Administration can approve the vaccine's use for younger children.
That could occur within the next few years.
ABOUT THE DISEASE
What is hepatitis A?
A serious liver disease caused by the hepatitis A virus, found in
the stools of people with the disease.
How is it spread?
Generally through close personal contact, sometimes by eating
food or drinking water contaminated with the virus. About 15 percent
of cases are traced to day-care centers.
How do you prevent it?
Wash your hands.
What are the symptoms?
Hepatitis A has a variety of symptoms: from mild ``flu-like''
illness to the more-serious yellowing of the eyes, severe stomach
pains and diarrhea that might require hospitalization. It can cause
death.
Unlike hepatitis B and C, hepatitis A does not permanently damage
the liver.
How is it treated?
Vaccination is the best protection. The vaccine starts working 14
days after it is given, and it is effective for at least 20 years.
A shot of immune globulin provides immediate protection against
the virus for three to five months.
- Source: Centers for Disease Control and Prevention KEYWORDS: VACCINE HEPATITIS A CHILDREN HEALTH
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