s of international adoptees is estimated at 106 (range: 90--819) per 100,000 household contacts of international adoptees within the first 60 days of their arrival in the United States (CDC, unpublished data, 2009). By comparison, according to surveillance data, the estimated rate of symptomatic hepatitis A in the U.S. general population in 2007 was 1.0 per 100,000 population (10).
Based on this evidence, on February 25, ACIP updated its guidance by recommending hepatitis A vaccination for all previously unvaccinated persons who anticipate close personal contact (e.g., household contact or regular babysitting) with an international adoptee from a country of high or intermediate endemicity during the first 60 days following arrival of the adoptee in the United States. The first dose of the 2-dose hepatitis A vaccine series should be administered as soon as adoption is planned, ideally 2 or more weeks before the arrival of the adoptee.
- CDC. Update: prevention of hepatitis A after exposure to hepatitis A virus and in international travelers: updated recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2007;56:1080--4.
- CDC. Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2006;55(No. RR-7).
- Krugman S, Giles JP. Viral hepatitis: new light on an old disease. JAMA 1970;212:1019--29.
- Tassopoulos NC, Papaevangelou GJ, Ticehurst JR, Purcell RH. Fecal excretion of Greek strains of hepatitis A virus in patients with hepatitis A and in experimentally infected chimpanzees. J Infect Dis 1986;154:231--7.
- Armstrong GL and Bell BP. Hepatitis A virus infections in the United States: model-based estimates and implications for childhood immunization. Pediatrics 2002;109:839--45.
- Glikson M, Galun E, Oren R, Tur-Kaspa R, Shouval D. Relapsing hepatitis A: review of 14 cases and literature survey. Medicine 1992;71:14--23.
- Williams I, Bell B, Kaluba J, Shapiro C. Association between chronic liver disease and death from hepatitis A, United States, 1989--92 [abstract no. A39]. IX Triennial International Symposium on Viral Hepatitis and Liver Disease. Rome, Italy, April 21--25, 1996.
- Fischer GE, Teshale EH, Miller C, et al. Hepatitis A among international adoptees and their contacts. Clin Infect Dis 2008;47:812--4.
- Advisory Committee on Immunization Practices. ACIP presentation slides: February 2009 meeting. Hepatitis vaccines. Available at http://www.cdc.gov/vaccines/recs/acip/slides-feb09.htm#hev.
- CDC. Surveillance for acute viral hepatitis---United States, 2007. MMWR 2009;58(No. SS-3).
* Additional information available at http://adoption.state.gov/news/total_chart.html.
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Date last reviewed: 9/17/2009