Journal of Infectious Diseases Advance Access published March 17, 2015
1 Letter to the Editor in Response to the Editorial Commentary by Dr. Kenrad E. Nelson entitled, “The Changing Epidemiology of Hepatitis A Virus Infections in the United States”
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Kathleen N. Ly, R. Monina Klevens, Ruth B. Jiles
Division of Viral Hepatitis, NCHHSTP, Centers for Disease Control and Prevention
us an M pt ed ce Ac Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Downloaded from http://jid.oxfordjournals.org/ at Middle Tennessee State University on March 22, 2015
Correspondence: [email protected]
2 Dear Editors:
We appreciate the Editorial Commentary by Nelson (1) and agree that the data in our study show
cr ipt
significant declines over time in the incidence of hepatitis A, most likely as a result of successful implementation of childhood hepatitis A vaccination in the United States. At the same time, our
study of over 80,000 reported cases of hepatitis A, identified from state health departments from
1999-2011, showed a significant increase over time in hepatitis A-associated hospitalizations and
us
We wish to clarify a statement by Nelson that we recommended immunization of all adults. Rather, because of the hepatitis A vaccine’s highly immunogenic properties (3, 4), we suggested
an
that future studies explore a one-dose hepatitis A vaccine strategy among adults as a way to possibly prevent complications of future outbreaks.
M
Regarding the declines in hepatitis A among adults of all ages, we analyzed more recent data from our national surveillance system for the years 2000 extended to 2013. All reported cases of hepatitis A in the United States were examined, regardless of hospitalization or mortality status.
pt ed
A 29.7% increase in the number of reported cases of hepatitis A was found from 1,376 in 2011 to 1,756 in 2013 (Table 1). The data further revealed that from 2000-2013, both the mean age and the proportion of persons with hepatitis A aged >20 years increased. In 2000, 56.2% of reported hepatitis A cases were among persons aged 20-59 years. In 2013, the proportion of cases in this age group increased to 65.3%. The mean age of all reported cases of hepatitis A also increased from 29.7 years in 2000 to 43.6 years in 2013. These additional analyses of more recent data
ce
document not only a continuing increase in the number of hepatitis A cases reported, but also an increase in the number of cases among older adults. In view of the success of hepatitis A vaccination in protecting young persons (aged
1 Letter to the Editor in Response to the Editorial Commentary by Dr. Kenrad E. Nelson entitled, “The Changing Epidemiology of Hepatitis A Virus Infections in the United States”
cr ipt
Kathleen N. Ly, R. Monina Klevens, Ruth B. Jiles
Division of Viral Hepatitis, NCHHSTP, Centers for Disease Control and Prevention
us an M pt ed ce Ac Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Downloaded from http://jid.oxfordjournals.org/ at Middle Tennessee State University on March 22, 2015
Correspondence: [email protected]
2 Dear Editors:
We appreciate the Editorial Commentary by Nelson (1) and agree that the data in our study show
cr ipt
significant declines over time in the incidence of hepatitis A, most likely as a result of successful implementation of childhood hepatitis A vaccination in the United States. At the same time, our
study of over 80,000 reported cases of hepatitis A, identified from state health departments from
1999-2011, showed a significant increase over time in hepatitis A-associated hospitalizations and
us
We wish to clarify a statement by Nelson that we recommended immunization of all adults. Rather, because of the hepatitis A vaccine’s highly immunogenic properties (3, 4), we suggested
an
that future studies explore a one-dose hepatitis A vaccine strategy among adults as a way to possibly prevent complications of future outbreaks.
M
Regarding the declines in hepatitis A among adults of all ages, we analyzed more recent data from our national surveillance system for the years 2000 extended to 2013. All reported cases of hepatitis A in the United States were examined, regardless of hospitalization or mortality status.
pt ed
A 29.7% increase in the number of reported cases of hepatitis A was found from 1,376 in 2011 to 1,756 in 2013 (Table 1). The data further revealed that from 2000-2013, both the mean age and the proportion of persons with hepatitis A aged >20 years increased. In 2000, 56.2% of reported hepatitis A cases were among persons aged 20-59 years. In 2013, the proportion of cases in this age group increased to 65.3%. The mean age of all reported cases of hepatitis A also increased from 29.7 years in 2000 to 43.6 years in 2013. These additional analyses of more recent data
ce
document not only a continuing increase in the number of hepatitis A cases reported, but also an increase in the number of cases among older adults. In view of the success of hepatitis A vaccination in protecting young persons (aged
