The Maine Center for Disease Control and Prevention (Maine CDC) is investigating a third case of acute hepatitis A. All three are residents of Waldo County and at least one attended a number of social functions in different areas of Maine while infective which included attendees from across the state. We therefore believe other people may be at risk for contracting the illness and may be showing signs and symptoms of it in the coming days and weeks.
Hepatitis A is an uncommon disease in Maine. An average of 11 cases are identified in Maine each year. Hepatitis A can result in mild illness in children; many will be asymptomatic. In adults, hepatitis A infection can range in severity from mild to life threatening. Case fatality can reach 1.8% in adults over 50 years of age. Individuals are considered infectious during the latter half of the incubation period and for approximately 1 week after onset of jaundice. The virus is excreted in feces and is transmitted by the fecal-oral route. Good hand washing is key to limiting disease transmission.
Area health care providers are encouraged to consider hepatitis A infection in persons with recent onset of symptoms, including, jaundice, fever, anorexia, fatigue, nausea, dark urine, clay colored stools, diarrhea, and abdominal discomfort. Diagnostic testing should include hepatitis A IgM antibody and liver enzymes (AST/ALT). Interpretation of a positive IgM test for HAV is difficult in a recently immunized individual. IgM positive results can occur from either natural infection or immunization. Confirmation of infection in recently immunized individuals is usually dependent on clinical signs and elevated liver enzymes. Report all cases of Hepatitis A to the Maine CDC Disease Reporting and Consultation Line: 1-800-821-5821.