Hepatitis A infections Linked to Children Adopted from Ethiopia and their Family Contacts

 

The Centers for Disease Control and Prevention (CDC) has recently received reports of hepatitis A in children and adults linked to adoptees from Ethiopia. Hepatitis A is a liver disease caused by the hepatitis A virus. Symptoms usually occur abruptly and include fatigue, abdominal pain, loss of appetite, nausea, jaundice (yellowing of the skin or eyes), and diarrhea. Jaundice is common in adults but rare in children. Most children under the age of 6 years do not get sick from the infection, but can spread it to older children and adults, who often become ill. Older persons and persons with chronic liver disease can have more serious illness. The overall mortality rate from hepatitis A is 0.3%, but it is 1.8% among persons aged ≥50 years. Symptoms generally last up to 2 months; there is no chronic (long-term) form of the disease.

 

The virus is found in the stool (feces) of persons with hepatitis A. It is usually spread from person to person by putting something in the mouth that has been contaminated with stool. Frequent hand washing with soap and water, particularly after using the bathroom, changing a diaper, and before preparing or eating food, is very important in preventing the spread of hepatitis A.

 

To prevent hepatitis A virus infections, CDC recommends that travelers to areas with high rates of hepatitis A, including Ethiopia, receive hepatitis A vaccine as soon as travel is considered.  CDC also recommends that all children ≥ 1 year of age receive the hepatitis A vaccine. Other household members and caregivers of children adopted from Ethiopia should consider being vaccinated before adopted children are brought to the United States. 

 

Adopted children, household members or other persons experiencing symptoms of hepatitis A should contact a health-care provider for an evaluation.  Persons exposed to hepatitis A who have not been previously immunized should contact their health-care provider or local health department to determine if they should receive an immunization or immunoglobulin that might prevent the illness.  More information about hepatitis A is available at http://www.cdc.gov/ncidod/diseases/hepatitis/.

 

CDC recommends that all international travelers consult a travel health-care provider 4-6 weeks prior to travel to determine if any other measures, such as immunizations or medications, are indicated for the planned itinerary.  Vaccine-preventable diseases, such as measles and mumps, are still common in many parts of the world, including developed countries. The CDC website (http://www.cdc.gov/travel/) has a specific section for Traveling with Children, which includes general health advice for international adoptees and their adoptive parents, and Travel Notices, which describe current disease information of interest to travelers.