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Hepatitis A epidemy in children hospitalized at the Department of Pediatric Infectious Diseases, University Hospital, Brno, from March 2016 to March 2017


Authors: M. Malá 1;  V. Musil 1;  I. Čapovová 1;  L. Klapačová 1;  R. Ciupek 2;  J. Bednářová 3;  L. Krbková 1
Authors‘ workplace: Klinika dětských infekčních nemocí LF MU a FN Brno 1;  Protiepidemický odbor Krajské hygienické stanice Jihomoravského kraje se sídlem v Brně 2;  Oddělení klinické mikrobiologie, FN Brno 3
Published in: Čes-slov Pediat 2017; 72 (7): 388-395.
Category:

Overview

Objective:
To evaluate the epidemy of hepatitis A in children from 0 to 18 years admitted for compulsory isolation at the Department of Pediatric Infectious Diseases, University Hospital, Brno, between March 2016 and March 2017 from Brno and the South Moravian Region.

Methods:
A retrospective study evaluated pediatric patients (0–18 years) hospitalized for hepatitis A (VHA) confirmed by the serological positivity of anti-HAV IgM antibodies. We evaluated age, sex, contact with infection, interval from the beginning of clinical symptoms to date of admission, duration of hospitalization, clinical symptoms, vaccination against VHA.

Results:
61 patients (26 girls and 35 boys) were hospitalized with VHA diagnosis. The youngest patient was 12 months old, the oldest 18 years old. The mean age of patients was 6.63±4.48 years, median 6 years. The average length of hospitalization was 11.3±7.52 days. At the age of 1–3 years, 19.7% of patients were hospitalized, 27.9% at age 3–6, 31.1% at age 6–12, 21.3% at age 12–18. In 19.7% cases an inicteric form of VHA was present, in 63.9% an anicteric form, in 16.4% an inaparent form. Epidemiologically significant contact with the infection was recorded in 90.2% of cases. Contacts prevailed in the family or pre-school and school facilities. The most common symptoms were symptoms of the gastrointestinal system, icterus and subfebrilia or febrilia. The clinical course of VHA was benign, asymptomatic infections were numerous. In 98.4% of patients, the course of VHA was uncomplicated, the prolonged course with laboratory relapse was recorded in 1.6% of cases. 24.6% of patients were prophylactically vaccinated for up to one month prior admission.

Conclusion:
In 2016 and 2017, the largest epidemic of VHA occurred in SMR since 1989, cases from the SMR constituted a half of all cases in the Czech Republic. The anicteric form prevailed among children. The age groups represented the most in children (0–18 years) were children in pre-school and younger school age. Early vaccination of contacts is a very important precaution limiting the spread of the disease.

Key words:
hepatitis A, children, vaccination, icterus, isolation, epidemiology


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