Viral hepatitis: A, B, C, D, and E--prevention.

Abstract

The article in the June 1992 issue of Pediatrics in Review included a detailed discussion of the etiology, pathogenesis, clinical manifestations, course, complications, epidemiology, and prognosis of hepatitis A, B, C, D, and E. This second section reviews prevention and treatment of these infections. Prevention of Hepatitis A GENERAL MEASURES Procedures designed to prevent fecaloral spread of hepatitis A virus should be used for control. These include scrupulous handwashing, proper sterilization of food utensils, fly abatement, and exclusion of potentially infectious food handlers. Although close contact is the most common mode of transmission, common source epidemics stemming from contaminated food, milk, and water supplies may occur. PASSIVE IMMUNIZATION Postexposure prophylaxis with standard immune globulin is recommended for all individuals who have had intimate exposure to a person with the disease. Immune globulin also is indicated for persons living in the same household because they are likely to have contact with the virus. However, routine use of immune globulin in schools, offices, and factories is not warranted; disease spread is unlikely under the conditions existing in these open facilities. The recommended 0.02-mL/kg dose of immune globulin should be given within 48 h, if possible, but not later than 1 wk after exposure. Preexposure prophylaxis with standard immune globulin is recommended for persons traveling to or working in areas where type A hepatitis is highly endemic.