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The Changing Epidemiology of Acute Hepatitis A in Texas

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Presentation on theme: "The Changing Epidemiology of Acute Hepatitis A in Texas"— Presentation transcript:

1 The Changing Epidemiology of Acute Hepatitis A in Texas
Rachel Wiseman, MPH, Lucille Palenapa, MS; Linda Gaul, PhD Emerging and Acute Infectious Disease Branch Texas Public Health Association Annual Education Conference April 22, 2010

2 Overview Describe how hepatitis A virus has
decreased in Texas since the licensing of a vaccine Vaccine requirements in Texas Hepatitis A incidence Hepatitis A distribution

3 Hepatitis A Epidemiology
Reservoir Humans Transmission Fecal-oral route; person-to-person or ingestion of contaminated food or water Communicability 1-2 weeks before onset to week after onset Temporal Pattern None Incubation Period Avg days (range days)

4 CDC Hepatitis A Vaccine Recommendations
1995, introduction of vaccine and recommended targeted vaccination of high-risk individuals 1999, recommended targeted hepatitis A vaccine programs for people two years of age and older residing in high incident states old Children are often asymptomatic and can be unknown sources of infection Texas identified the counties with the largest burden of hepatitis A and targeted those for vaccine requirements 2005, recommended vaccination of all children months of age and older

5 Texas Counties Requiring Hepatitis A
For Childcare and School Entry, 1999 32 Counties Requiring Hepatitis A Vaccination

6 Texas Counties Requiring Hepatitis A
For Childcare and School Entry, 2003 Seven counties, were added to the vaccination requirement. 39 Counties Requiring Hepatitis A Vaccination

7 Texas Counties Requiring Hepatitis A
For Childcare and School Entry, 2005 Counties requiring vaccine for childcare entry. Counties requiring vaccine for school and childcare entry (n=40).

8 Current Hepatitis A Vaccine Requirements
Child-Care Statewide for all children attending a child-care facility, including pre-K After-school care not affected School Must have 2 doses for entering kindergarten Statewide requirement (this is new for the school year!)

9 Reported Cases of Hepatitis A in Texas 1995-2009*
Hepatitis A vaccine licensed in 1995 Incidence rates per 100,000 population 9.3 1.1 16.1 *2009 data is provisional as of 4/6/2010.

10 Percent of Hepatitis A Cases by Age Group

11 Incidence Rates of Hepatitis A by Age Group

12 Percent of Hepatitis A Cases by Gender

13 Percent of Hepatitis A Cases by Race

14 Incidence Rates of Hepatitis A Cases by Race

15 Percentage of Cases in Age Category by Race, 2008
Hispanics Whites

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19 Summary Requiring school/childcare vaccination in specific locations has reduced incidence across the state in all age groups Racial disparities in disease incidence have been eliminated Expansion of vaccination requirements should help to continue these trends


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