An Outbreak of Hepatitis A in South Korean Military Personnel: A Clinical and Epidemiologic Study

Han, Sung Hee; Lee, Soong Hwan; Roh, Byung Joo; Shim, Seong Chun; Cho, Seung Chul; Sohn, Joo Hyun; Lee, Dong Hoo; Kee, Choon Suhk

Abstract

BACKGROUND/AIMS: Increasing the susceptibility of young populations to HAV infection could result in an outbreak in a high-risk group. The author investigated the characteristics of hepatitis A outbreaks among Korean military personnel to obtain the fundamental data for determining the necessity for selective HAV vaccination.
METHODS
A case was defined as a person who had an onset of an illness compatible with acute viral hepatitis A between 4 February and 6 April 1998.
RESULTS
A widespread outbreak of hepatitis A affected 102 military personnel. The epidemic curve indicated a common-source exposure in the initial stage. At the end of the first month of the initial onset, the occurrence was specific to the location of the military post. Investigation suggested that contamination most likely occurred prior to the local distribution of food. The mean age was 23 years. The overall attack rate was 91 cases per 10000 persons at risk. All cases were jaundiced. The most frequently reported symptoms included icteric sclerae, dark urine, anorexia, malaise and fatigue, nausea, fever, abdominal pain, headache, upper respiratory symptoms, vomiting, itching, diarrhea, light-colored stools, myalgia, arthralgia, and skin rash. The laboratory test showed the serum total bilirubin of 5.5 mg/dL, AST of 344 IU/L, and ALT of 868 IU/L (mean value).
CONCLUSION
All patients were clinically apparently diseased with jaundice and were completely recovered. The outbreak was food borne common-source exposure. The changing epidemiology hepatitis A in Korea calls for the economic evaluation of costs and benefits for selective HAV vaccination in high risk adult groups including military personnel.