THE ROLE OF YOUNG-CHILDREN IN A COMMUNITY-WIDE OUTBREAK OF HEPATITIS-A

An Hasidic Jewish community has experienced recurrent hepatitis A outb reaks since 1980. To assess risk factors for illness during a 1985-6 o utbreak, the authors reviewed case records and randomly selected 93 ho useholds for an interview and serologic survey. In the outbreak, 117 c ases of hepatitis A were identified, with the highest attack rate (4.2 %) among 3-5 year olds. Among the survey households, the presence of 3-5 year olds was the only risk factor that increased a household's ri sk of hepatitis A (indeterminant relative risk, P = 0.02). Furthermore , case households from the outbreak were more likely to have 3-5 year olds than were control households from the survey (odds ratio = 16.4, P < 0.001). Children 3-5 years old were more likely to have hepatitis A and may have been the most frequent transmitters of hepatitis A in t his community. Hepatitis A vaccination of 3-5 year olds can protect th is age group and might prevent future outbreaks in this community.