Targeted program drastically reduced hepatitis A in U.S.

According to a newly released study, the number of cases of hepatitis A have fallen by 76 percent in the United States since a vaccination campaign targeted children in communities with the highest rates of the disease.

During the 1980s and 1990s, 26,000 cases of hepatitis A were reported to public health officials each year, and that was feared to be a fraction of the actual cases that occurred but were not reported because many victims do not have symptoms.

The study from the U.S. Centers for Disease Control and Prevention, says that more than half of the estimated infections of the disease, which can cause flu-like symptoms and jaundice, occurred in children.

Hepatitis is a viral infection that attacks the liver, and there are several varieties.

In general, type A is considered less threatening than some others that can cause liver failure and death, it is spread by fecal contamination of water and food.

According to the report, in 1995 a highly effective hepatitis A vaccine became available in the United States for children age 2 or older.

In the following year, on the recommendation of medical experts, children living in communities with higher incidence of the disease, such as Native American settlements were targeted with the vaccine.

Also targeted were adults with a high risk of the disease, such as men who have sex with men, users of illegal drugs and travelers to countries where the disease is endemic.

Then in 1999, recommendations for routine vaccination were expanded to include children living in 17 states that had consistently elevated hepatitis A rates.

The researchers found that by 2003, cases had fallen to 76 percent to 2.6 per 100,000 people,compared to the early and mid-1990s.

The report says declines were greatest in children ages 2 to 18, at 87 percent.

The report concludes that the regional, targeted vaccination approach is a new approach, but completely eliminating the disease would require "expansion of existing recommendations to include routine vaccination of all U.S. children".

The report is published in the current edition of JAMA: The Journal of the American Medical Association.