Exposure to school children as a risk factor in a community outbreak of hepatitis A in young adults: a case control study

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To investigate risk factors during a community outbreak of hepatitis A we carried out a case- control study of 35 cases and 49 matched controls using an interviewer-administered questionnaire on clinical history, travel, household details including domestic toilet facilities, infectious contacts, and food history. Of 99 cases notified in the city during the outbreak year, 50 (51%) were young adults age 15–34 years. Hepatitis A infection was independently associated with household contact with a case (P = 0.0005), and sharing a household with children in primary school (OR 3.4, 95% CI 1.2–9.5, P = 0.008) with risk increasing with number of primary-school pupils in the household (χ2for linear trend 6.47, P = 0.01). We concluded that in a population with a low prevalence of hepatitis A, adults who live in the same household as primary-school-age children are at increased risk of acquiring the infection during community outbreaks.

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