What did we learn from the Shanghai hepatitis A epidemic?

  title={What did we learn from the Shanghai hepatitis A epidemic?},
  author={W. Graham E. Cooksley},
  journal={Journal of Viral Hepatitis},
  • W. Cooksley
  • Published 1 April 2000
  • Medicine
  • Journal of Viral Hepatitis
A major outbreak of hepatitis A (HAV), associated with consumption of raw clams, occurred in Shanghai, China in 1988. Over 300 000 cases were reported, of which 47 (0.015%) were fatal. An elevated mortality rate was observed in hepatitis B surface antigen (HBsAg)‐positive patients (0.05%). The majority of these patients were also hepatitis B e antigen (HBeAg)‐positive, indicating active liver disease and high viral replication rates. The increased mortality in hepatitis B virus (HBV)/HAV… 
Perspectives on Acute Hepatitis A Control in Korea
This year's epidemic of hepatitis A is a predictable outcome for vulnerable populations, therefore, effective acute hepatitis A control and prevention strategies are needed, particularly for those in their 20s and 30s.
Hepatitis A Virus
Progressive improvement in sanitary and socioeconomic conditions in countries with high and intermediate endemicity is leading to a shift in the age of infection which becomes more symptomatic >5 years of age and especially in adolescents and adults, in whom infection causes significant morbidity and incapacitation.
Epidemiology of Hepatitis A: Past and Current Trends
The age of acquiring hepatitis A virus is also shifting toward adolescents and adults, which has led to a more symptomatic disease, since hepatitis A infection among children is usually asymptomatic; this is known as the paradox of Hepatitis A epidemiology.
Hepatitis Requires Public Health Action
It is estimated that worldwide, HAV caused approximately 11 000 deaths in 2015, and public health workers are at high risk of contracting the disease as a part of their work and should be its first recipients of available vaccines.
Hepatitis A vaccine should receive priority in National Immunization Schedule in India
The government of India should give this vaccine against hepatitis A as a priority in the national immunization schedule since it is easier to integrate with the existing schedule, protects those who have no antibodies, and protects children by the time they attend day care.
Hepatitis B infection in China: the stigma behind the stigmata
  • Ken Liu
  • Medicine
    Liver international : official journal of the International Association for the Study of the Liver
  • 2016
The medical disadvantage of CHB in China appears to be declining, however, a significant social disadvantage exists in CHB sufferers, which is often neglected.
Susceptibility to hepatitis A in patients with chronic liver disease due to hepatitis C virus infection: Missed opportunities for vaccination
It is found that HAV testing and vaccination rates were low in clinical practice, and public health programs to increase awareness about HAV vaccination in patients with chronic liver disease are needed.
KM-based Treatment of Viral Hepatitis A accompanied with Pancreatitis: A case report
Owing to improvement of public health facility and vaccination program, the incidence of symptomatic acute hepatitis A has been minimized in South Korea and recently, however there were nationwide outbreaks of acute liver disease.
Need for hepatitis A prevention in patients with chronic liver disease in the changing epidemiological setting of India
The burden of chronic liver disease in India is high, particularly among middle-aged men, with nearly 220,000 deaths due to cirrhosis in 2017, and it may be the time to recommend HAV vaccination among people with CLD in India.
Viral hepatitis in international travellers: risks and prevention.
  • M. Khuroo
  • Medicine
    International journal of antimicrobial agents
  • 2003
Hepatitis A is the most common form of viral hepatitis in travellers and cumulative data have shown a risk of 3-6 cases/1,000 persons/month of stay whereas the risk of acquiring hepatitis B is 10 times lower.


Is hepatitis A more severe in patients with chronic hepatitis B and other chronic liver diseases?
  • E. Keeffe
  • Medicine
    The American journal of gastroenterology
  • 1995
The purpose of this review is to analyze the published literature addressing the clinical course and outcome of acute hepatitis A in patients with chronic HBV infection and other chronic liver diseases to determine if hepatitis A is more severe in these patients.
Viral cross talk: intracellular inactivation of the hepatitis B virus during an unrelated viral infection of the liver.
The results confirm the ability of these inflammatory cytokines to abolish HBV replication; they elucidate the mechanism likely to be responsible for clearance of HBV in chronically infected patients who become superinfected by other hepatotropic viruses; they suggest that pharmacological activation of intrahepatic macrophages may have therapeutic value in chronic HBV infection; and they raise the possibility that conceptually similar events may be operative in other viral infections.
Hepatitis A Infection in Chronic Carriers of Hepatitis B Virus
By routine screening for serologic markers of hepatitis A and B in patients with acute hepatitis, 30 chronic carriers of hepatitis B virus with serologic evidence of acute hepatitis A and two
Clinical spectrum and natural history of hepatitis A in a 1988 Shanghai epidemic
  • Viral Hepatitis and Liver Disease
  • 1991
Hepatitis A infection in chronic carriers of hepatitis B infection
  • Hepatology
  • 1983
[A clinical study on acute hepatitis A---with special reference to its occurrence in HBsAg carriers].
  • C. Yang, C. Chu, +6 authors C. S. Wu
  • Medicine
    Taiwan yi xue hui za zhi. Journal of the Formosan Medical Association
  • 1983