But Hepatitis A is a disease of the unclean! WTF?!

It was a little over a year ago that I told you what the National Vaccine Information Center had to say about hepatitis A. Oh, yes, they do mention that you can contract Hepatitis A through contaminated food, but they seem to make a special effort to tell you that you’re okay in the good old USA:

“Hepatitis A is spread almost exclusively by the fecal-oral route and is most often associated with poor sanitation and hygiene, and overcrowded living conditions.

It also is associated with lower socioeconomic status, certain sexual practices, and injected drug use. However, outbreaks of hepatitis A have also occurred in restaurants, daycare centers, nursing homes, and other institutions and community settings.

Some outbreaks of hepatitis A have been traced to contaminated food, water, milk, frozen raspberries and strawberries, and shellfish.

Among adults with identified risk factors, the majority of cases are among men who have sex with men, persons who use illegal drugs, and international travelers. Because transmission of hepatitis A during sexual activity probably occurs because of fecal-oral contact, measures typically used to prevent the transmission of other STDs (e.g., use of condoms) do not prevent hepatitis A transmission.

Hepatitis A infections also have been linked to children adopted from certain countries.”

Those damned immigrant children! Oh, and this:

“Poor personal hygiene can increase the chances of spreading hepatitis A. That is why 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.

It also has been identified as a risk factor in daycare centers and intensive care neonatal units.

Travel to Third World countries, where hepatitis A is more prevalent, also is an identified risk factor for getting this infection.”

They seem to be obsessed with third world countries. While it is true that there is a higher incidence of Hep A in third world countries, there is also plenty of Hep A to go around here in the States. But have no fear, there is a vaccine, and this is what that USA Today article has to say about the vaccine and the current outbreak:

“Of the 79 people in seven states who have become ill with the deadly liver disease, only one was a child. Health officials initially feared that the youngest would be hit hardest because the contaminated frozen berries are used in smoothies, popsicles and other warm-weather treats popular among children.

They credit routine vaccinations against hepatitis A since 2006 with protecting children.

“The very, very small number of children involved in this outbreak probably reflects the high vaccination coverage as the result of the routine immunization,” said John Ward, who directs the viral hepatitis program at Centers for Disease Control and Prevention (CDC).

The one child who did become ill, a 2-year-old, was not vaccinated, Ward said.”

Imagine that. A vaccine that works, is safe, and can keep children safe from an unneeded medical condition. (Not that there is a “needed” medical condition, but anti-vaxxers will tell you that you “need” chickenpox and measles to make you “stronger.”) Of course, I can play Devil’s Advocate and tell you that children are more likely to be asymptomatic. So you’re less likely to pick up cases of children being sick. BUT you’d see the symptomatic adults that take care of those children. That’s the catch. That’s where the misinformation dealers try to trick you.

I can’t tell you my sources, of course, but those adult cases right now have had children in the household tested, and they’re negative for hepatitis A IgM, the antibody indicator of acute infection. They’re also negative for Hep A virus in the stool. Imagine that.

Of course, leave it up to NVIC to tell you that the vaccine is horrible:

“There is a gap in medical knowledge in terms of predicting who will have an adverse reaction to the hepatitis A vaccine and who will not.

However, reading the manufacturer’s product package inserts (see below) under “contraindications, warnings and precautions, and adverse reactions,” will help you weigh the vaccine’s benefits and risks before making a decision for yourself or your child.

Within the hepatitis A manufacturers’ vaccine package inserts, some of the adverse events reported ranged from fever, to nausea and loss of appetite, to dizziness, and neuromuscular symptoms, including Guillian Barre Syndrome.

According to the CDC, some of the other risks and side effects from this vaccine are:

Mild problems

  • Soreness where the shot was given (about 1 out of 2 adults, and up to 1 out of 6 children)
  • Headache (about 1 out of 6 adults and 1 out of 25 children)
  • Loss of appetite (about 1 out of 12 children)
  • Tiredness (about 1 out of 14 adults)
  • If these problems occur, they usually last 1 or 2 days.

Severe problems

  • Serious allergic reaction, within a few minutes to a few hours of the shot (very rare)”

I bolded and underlined the part about the vaccine package insert because it’s a common ploy of the anti-vaccine groups. See, the manufacturers need to put in the inserts those things that were reported during vaccine trials, whether they happened as a cause of the vaccine or not. If someone caught the flu during the trials, guess what? You have to put in there that “fever” or “nausea” was reported. Guillain-Barre Syndrome happens on it’s own in 1 out of 1,000,000 people, so they would have had to put that on the vaccine insert if one of the people during the trial got it. Furthermore, they need to put in the insert anything that happens after it’s licensed and it’s causally associated with the vaccine. There have been no cases of GBS causally associated with the vaccine, and people who get the vaccine are not at a higher risk for GBS.

So what do we have here? We have an outbreak of hepatitis A in the United States of America, the world’s lone superpower (as long as you don’t tell the Chinese). We’re clean, we wash our hands, and we screen our “third world babies” when we adopt them. (And, in Texas, we don’t have men who have sex with men. [Yeah, we do.])  In that outbreak, one child has been confirmed as a case, and that child was not vaccinated. The vaccinated children in the household of cases tested so far are not sick, and not even infectious (no virus in stool).

One of my colleagues said the other day that people who handle food, from the farm to the plate, should be required to get the Hep A vaccine. I completely agree. Since most of the cases in the US are primarily associated to contaminated food, this would seriously cut down on the number of outbreaks. However, I would go one step further and vaccinate all inmates as they are incarcerated, anyone who has liver disease, and all children, so they don’t pass it on to unsuspecting adults in their family or to other children in their schools.

After all, the benefits outweigh the risks.

9 thoughts on “But Hepatitis A is a disease of the unclean! WTF?!

  1. I got immunized against HAV and HBV when I started working at a hospital. The vaccines weren’t available when I was a child, but I cringe when I hear parents claiming they won’t give their child an HBV vaccine. The refrain seems to be that “their” precious kid would never have unprotected sex or IV drugs, so it’s not necessary. So you know they’re delusional on top of being uninformed.

    • That delusional thinking isn’t only with antivaxers.
      My sister-in-law didn’t want her children to attend sexual educational classes in school. To the point of signing them out of those classes on the same delusional grounds, but from also a religious basis. She also wasn’t the most attentive in supervising her children’s activities, remarking when the eldest was two and doing something that risked bodily harm, “I don’t care, as long as they’re out of my hair”.
      The results were sadly predictable. The child became pregnant at 16, she refused, on religious grounds, to permit the child to have an abortion. She insisted that the child raise her child.
      So, mom now is of the age of consent, saddled with a child she doesn’t want and hampers her possibilities for further education. Dad is out of the picture. Grandmom insists she raise the child and gripes when asked to babysit because mom is working.
      Mom isn’t very attentive or interacting with the child, new boyfriend isn’t very good with the child, handling the child in ways that nearly resulted in my own personal intervention, which would have resulted in his hospitalization.
      It’s the most frustrating situation one can ever witness, it’s also quite sad.
      And one that I accurately predicted back when the children were two years old.

      I’m afraid to have my wife ask if the young women ever received an HPV vaccination. If they didn’t, certain high risk behaviors virtually guarantee infection.
      In a family who has a history of cervical cancer, breast cancer and PCOS. While the latter isn’t a risk factor for infectious disease, it’s something missed by the clinicians treating that entire family.

      Note to self: talk with the OB/GYN professor about that tenancy and see if that can be added in the suggested history, if it isn’t already added in the latest class.
      Never gripe about a situation if you can at least try to improve it.

      • Yes, I agree completely. Interestingly, though (and this is a generalization) even though it is the same delusion the anti-vaccine people seem to be more to the liberal/left end of the spectrum and the anti-abortion people seem to be more to the conservative/right end of the spectrum. I suppose delusion is not a matter of political preference but as I am quite liberal leaning myself and it’s always disheartening to see people that I share many beliefs with and see as enlightened turn around and start spewing pseudoscience.

        • It’s been my experience that those who are hard right or hard left tend to have difficulties with comprehending history, law and the realities of the world overall.
          Instead, they either see their fears or they see what they desire and mentally screen away that which disagrees with their world view.

  2. When I worked as a public health nurse, I remember participating in large post-exposure prophylaxis clinics, where we provided immune globulin shots to hundreds of restaurant patrons or people who had been exposed to “pre-washed” fresh produce/salads before the Hepatitis A vaccine became available.

    All those years working as a public health nurse served me well. I’m very “picky” when it comes to my choice of restaurants and I thoroughly wash all fresh produce, before I serve them at my table.

  3. When I was in elementary school in Mexico, there was a month or so where nearly everyone in my classroom was sick. Come to think of it, it may have been the whole school since they closed it. Anyway, several of my friends got yellow, and I remember one we went to visit at the hospital because he was very ill. My parents think that I must have caught hepatitis A too because I had some GI problems around the same time. To think that this is a mild disease or one that affects people at a lower rate than the side-effects of the vaccine is delusional. And to think that the virus and the disease will respect political boundaries is even worse.

    • Many years and years ago an entire office down the hall from where I worked became infected with hepatitis a. It was spread by the large bag of popcorn that someone brought in to share. One person ended up in the hospital. It was an engineering office, with some PhDs.

  4. A couple years back, my GP recommended I get the Hep A and Hep B series, since I was too old to have received them as a child and did not show any titers in my previous blood workup. I happily went along with the recommendation. Stories like this make me glad I did.

  5. Per the CDC, hepatitis A has declined in the US and China by 90% since the vaccine was introduced in 1992. Fortunately, we have antivaxers to correct that problem and ensure that the US moves forward to full third world nation status.

    Click to access ss5803.pdf

    Seriously though, if the vaccine was available when I was a child, I’d have a smaller liver. Picked up a hepatitis A infection, courtesy of dining out with my parents. It wasn’t fun.

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