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Few Americans are aware of a major epidemic that has taken hold of large areas of their country in recent years – by a disease that is easily diagnosed and prevented. Sadly, public – and even professional interest in these events have been overshadowed by COVID-19.
Hepatitis A had been largely under control until three years ago and can be easily prevented through the use of a safe and effective vaccine.
From January 2017 to January 2019, at least 26 separate outbreaks were reported, to a total of 11,628 cases and 99 deaths, nationwide. Homeless individuals and users of illicit drugs accounted for a large percentage of these patients.
The graph below shows that the number of reported cases, which had been declining steadily since 1997, has taken a dramatic upturn during the current epidemic.
As of September 2020, more than 1,000 cases have now been reported in each of seven states: Florida, Georgia, Indiana, Kentucky, Ohio, Tennessee, and West Virginia. Indeed, the total number of cases reported since the arrival of COVID-19 in the United States has reached 6,650 (to October 10, 2020) – a major concern to public health specialists.
Hepatitis A is a highly contagious disease that affects the liver. Infection may cause symptoms such as vomiting, jaundice, anorexia, dark urine, and light stools, occasionally accompanied by rash or arthritis. Symptoms normally persist between two to eight weeks, although the illness may last longer and be more severe in patients with underlying conditions.
The case-fatality rate of Hepatitis A ranges from 0.15% to 2.7%, with children faring better than adults.
At the time of writing, there is no known cure for Hepatitis A. To speed up recovery, it is recommended that patients get plenty of rest and avoid substances that may have adverse effects on the liver, such as alcoholic beverages and certain medications.
While most Hepatitis A patients recover with lifelong immunity to the disease, Hepatitis B and C may ‘reappear’ in the form of hepatic cirrhosis or hepatocellular carcinoma years after the acute illness.
Hepatitis B is responsible for 60% to 80% of the world’s primary liver cancer cases. Thankfully, its rates continue to decline in the United States:
The mode of transmission also differs among the three viruses. HepA is transmitted via the fecal-oral route, HepB, and HepC through the exchange of infected bodily fluids.
As of 1998, injecting-drug abuse accounts for 60% of Hepatitis C transmission in the United States: