BACKGROUND: Memphis and Shelby County, Tennessee, experienced an epidemic of hepatitis A in 1994 and 1995. More than 1700 cases were reported. OBJECTIVE: To characterize the clinical features of patients hospitalized during a large urban epidemic of hepatitis A. DESIGN: Retrospective chart review. SETTING: 15 acute care hospitals in Shelby County, Tennessee. PATIENTS: 256 patients hospitalized with acute hepatitis A. MEASUREMENTS: Laboratory findings (such as prothrombin time and bilirubin level), complications, and mortality. RESULTS: The median patient age was 26 years. Thirty-nine complications occurred in 35 patients. Twenty patients (8%) had extrahepatic complications, and 5 (2%) died. Patients 40 years of age and older were more likely to have serious complications, including death (P = 0.014). Sixty-seven patients (26%) presented with coagulopathy (prothrombin time > or = 3 seconds prolonged). Fifty-four patients (21%) had a bilirubin level greater than 170 micromol/L (10 mg/dL). CONCLUSIONS: During this epidemic, hepatitis A caused serious illness and death. Complications were more frequent in patients 40 years of age and older, but young, healthy persons were also at risk for severe complications.
BACKGROUND: Memphis and Shelby County, Tennessee, experienced an epidemic of hepatitis A in 1994 and 1995. More than 1700 cases were reported. OBJECTIVE: To characterize the clinical features of patients hospitalized during a large urban epidemic of hepatitis A. DESIGN: Retrospective chart review. SETTING: 15 acute care hospitals in Shelby County, Tennessee. PATIENTS: 256 patients hospitalized with acute hepatitis A. MEASUREMENTS: Laboratory findings (such as prothrombin time and bilirubin level), complications, and mortality. RESULTS: The median patient age was 26 years. Thirty-nine complications occurred in 35 patients. Twenty patients (8%) had extrahepatic complications, and 5 (2%) died. Patients 40 years of age and older were more likely to have serious complications, including death (P = 0.014). Sixty-seven patients (26%) presented with coagulopathy (prothrombin time > or = 3 seconds prolonged). Fifty-four patients (21%) had a bilirubin level greater than 170 micromol/L (10 mg/dL). CONCLUSIONS: During this epidemic, hepatitis A caused serious illness and death. Complications were more frequent in patients 40 years of age and older, but young, healthy persons were also at risk for severe complications.
Authors: E E Epson; A Cronquist; K Lamba; A C Kimura; R Hassan; D Selvage; C S McNeil; A K Varan; J L Silvaggio; L Fan; X Tong; P R Spradling Journal: Public Health Date: 2016-05-04 Impact factor: 2.427
Authors: Hee Won Moon; Jin Hee Cho; Mina Hur; Yeo-Min Yun; Won Hyeok Choe; So Young Kwon; Chang Hong Lee Journal: World J Gastroenterol Date: 2010-03-07 Impact factor: 5.742