Resolution 98-02

Controlling Hepatitis A

WHEREAS, the Centers for Disease Control and Prevention (CDC) consider hepatitis A to be at epidemic level when communities have rates of 50/100,000 or greater and community-wide public health approaches are required to break the cyclic recurrence of epidemics as well as to deal with epidemics when they occur,

WHEREAS, such community-wide public health approaches include public education about the disease, good sanitation and personal hygiene, with special emphasis on careful hand washing and sanitary disposal of feces;1

WHEREAS, each case of hepatitis A requires in depth screening by epidemiologists to identify high risk contacts who should receive immune serum globulin (ISG) which are public health resources that become strained during cyclic community-wide hepatitis A epidemics;

WHEREAS, hepatitis A is preventable with a safe and effective vaccine that is available to citizens/community members who choose to protect themselves and many communities throughout the United States, including the entire state of Oklahoma, have instituted school entry hepatitis A vaccination campaigns as a means of breaking the cycle of recurring epidemics, a strategy that CDC recently recommended to the US Public Health Service Advisory Committee on Immunization Practices (ACIP) for all high rate states, including Washington;

WHEREAS, vaccination of high-risk groups (e.g., injection drug users; homosexual men; people with chronic liver disease, especially hepatitis C2 people seeking evaluation and treatment at STD clinics)3 is the standard of care, outbreak or no outbreak, and since over 80% of correctional inmates are injection drug users,4 they fall into a targeted category for hepatitis A vaccination;

WHEREAS, by implementing employee hepatitis A vaccination programs, the food industry may reduce liabilities, protect the limited ISG supplies, and lessen the strain on public health resources that must be diverted to investigations when a food worker contracts hepatitis A5 ;

WHEREAS, CDC says "Hepatitis A vaccination programs represent an important strategy for preventing morbidity and mortality associated with cyclic hepatitis A epidemics in communities with high rates of diseases"6 and currently, "the ACIP recommends the use of hepatitis A vaccine for the control of outbreaks of hepatitis A in communities considered to have an intermediate rate (50-200/100,000) of hepatitis A infection"7 ;

WHEREAS, one of WSPHA’s goals is to help build a public health system in Washington State to prevent and control communicable disease;

THEREFORE BE IT RESOLVED that WSPHA endorses the multi-pronged approach to controlling hepatitis A. Implementing a program that includes the broadest spectrum of strategies represents the most comprehensive solution to community-wide epidemic control of hepatitis A. These strategies include:

  • Hepatitis A vaccination of high risk target groups and of people, especially children, in communities

and subpopulations with rates of 50/100,000 or more;

  • Comprehensive public education about the disease, good sanitation, personal hygiene, and the

availability of the vaccine;

  • Prompt epidemiologic assessment of hepatitis A cases in order to reach at risk contacts with ISG;
  • Outreach to the food industry about the constant need for vigilance regarding sanitation and hygiene,

and the availability of hepatitis A vaccine.

Adopted by the vote of the Membership assembled at the 1998 Annual Business meeting of the Association, October 5, 1998 in Yakima, Washington.

Signed by: George Hilton, WSPHA President

References:

  1. 1990, Benenson, A.S., Control of Communicable Diseases in Man.
  2. January 29, 1998, New England Journal of Medicine.
  3. 1998, Guidelines for Treatment of Sexually Transmitted Diseases.
  4. 1997, Bureau of Justice Statistics, Prison Inmates 1996.
  5. 1996 Archives of Internal Medicine.
  6. July 4, 1997, Morbidity and Mortality Weekly Report.
  7. 1998 Resolution No. 6/98 Vaccines for Children Program.