CEDAR GROVE, N.J., Feb. 18 (UPI) _ A Centers For Disease Control and Prevention advisory committee has recommended mandatory hepatitis A vaccination programs for children in 11 states where the rate of the disease is at least twice the national average.

The Advisory Committee on Immunization Practices said Arizona, Alaska, California, Idaho, Nevada, New Mexico, Oklahoma, Oregon, South Dakota, Utah and Washington all have a hepatitis incidence rate of at least 20 per 100,000 people. Combined, these states represent 22 percent of the total U.S. population but accounted for 50 percent of all reported hepatitis A cases from 1987 to 1997. The committee also said vaccination programs should be considered in states where the rate is at least 10 per 100,000, including Missouri, Texas, Colorado, Arkansas, Montana and Wyoming.

"The hepatitis A vaccine is wonderfully safe and marvelously effective," said Dr. Bill Schaffner, a committee member and chairman of the Dept. of Preventive Medicine at Vanderbilt School of Medicine in Nashville.

The recommendation covers children, ages 2 through 18, with younger children thought to be at greater risk. More than 30 percent of cases involve children under age 15. Hepatitis A, which results in $450 million in direct and associated costs each year, affects up to 200,000 Americans annually, with about 100 of those victims dying from it.

Schaffner said hepatitis A is found in the intestinal tract and fecal matter and is spread from person to person through fecal-oral transmission. One common way is small children who fail to wash their hands after using the bathroom and pass the virus to other youngsters, who take it home and spread it among family members.

"Hepatitis A wiped out most of my family for about six weeks," said Eileen Waldman, of Scottsdale, Arizona, whose 3-year-old son in 1997 brought the virus home from day care. Although the child showed only flu symptoms, Waldman said her doctor advised her to take him to a hospital emergency department for tests.

Waldman, who contracted the virus along with two other children, said despite very prompt medical treatment with immune gobulin (IG) shots, she missed five weeks of work and added that one child is still not fully recovered from all symptoms.

Schaffner said sometimes hepatitis A, which affects the liver, may often show itself through flu-like symptoms, so many victims aren't aware they've contracted the virus. More serious cases have the more pronounced and common symptom of a yellowing of the skin and eyes.

Hepatitis A also can be spread through food and water contamination. Dr. Tom Dobbins, a physician in Marshall, Mich., said his 8-year-old daughter was part of a major outbreak in his community stemming from contaminated strawberries. She ate the strawberries during a school lunch.

"It was about a month after she ate the strawberries then all of a sudden kids started getting sick," Dobbins said. "The incubation period was very long."

CDC investigators finally made the connection to strawberries but Dobbins said a fecal-oral contamination was made "somewhere along the food chain" for the strawberries to carry the virus.

The current recommendation is the second phase of a three-prong hepatitis A program. Two years ago, the first phase included a recommendation for vaccinations of adults who travel internationally and residents of small, ethnic communities, such as Indian reservations. Prior to this latest recommendation, Oklahoma, Texas and Arizona had already taken steps to mandate vaccinations for certain children.

The CDC committee's third phase, expected in two years, will be a recommendation that mandatory vaccination programs be adopted throughout the United States. But, as Schaffner put it, "All of the rest of you who would like to start on this now, go ahead."

(Written By Ellen Beck in Washington, DC)

_-

Copyright 1999 by United Press International

All rights reserved

_-

Copyright 1999 by United Press International