http://www.ncbi.nlm.nih.gov/pubmed/24659442

Mustafa Aydin1, Ugur Deveci1, Nilay Hakan2, Sukran Ozdiller1 and Feyza Girgin1

Hepatitis A infection is a widespread disease, accounting for 1.4 million cases annually worldwide. In high endemic areas, the reported incidence of Hepatitis A infection may reach 150 per 100,000 per year [2]. The clinical spectrum of Hepatitis A infection ranges from asymptomatic infection to fulminant hepatitis. Clinical manifestations depend on the age of host: less than 30 % of infected young children are symptomatic, while approximately 80 % of adults manifest severe hepatitis with remarkably elevated serum aminotransferases [3]. Acute liver failure occurs in less than 1 % of cases. Hepatitis A infection is the most common detected cause of fulminant hepatitis among children in our country as well as worldwide.

The application of a routine Hepatitis A virus vaccine among children will reduce the potential for the development of severe complications. Hepatitis A incidence has declined 92 % with universal vaccination of young children in United States [5]. Universal Hepatitis A virus immunization program has begun in Turkey since October 2012. Nearly 100 % of people develop protective levels of antibodies to the virus within one month after a single dose of the vaccine. Even though a single dose of the vaccine has protective effects; still, manufacturers recommend two vaccine doses to ensure a longer-term protection of about 5 to 8 y after vaccination.

Hepatitis A infection is an important public health problem in developing counties. Vaccination against hepatitis A virus is necessary for children older than one year. We believe that in addition to improved sanitation and food safety, the universal Hepatitis A virus immunization programs are the most important means in effort to reduce Hepatitis A virus infection and related severe complications.

References
1.Kumar KJ, Kumar HCK, Manjunath VG, Anitha C, Mamatha S. Hepatitis A in children- clinical course, complications and laboratory profile. Indian J Pediatr. 2014; 81:15–9.PubMedCrossRef

2. WHO/CDS/CSR/EDC/2000.7. Hepatitis A. World Health Organization. Department of Communicable Disease Surveillance and response. Available at: http://www.who.int7csr/disease/hepatitis/HepatitisA-whocdscsredc2000-pdf. Accessed 1 March 2013

3. Jeong SH, Lee HS. Hepatitis A: Clinical manifestations and management. J Intervirol. 2010; 53:15–9.CrossRef

4.Aydoğdu S, Ozgenç F, Yurtsever S, Akman SA, Tokat Y, Yağci RV. Our experience with fulminant hepatic failure in Turkish children: Etiology and outcome. J Trop Pediatr. 2003; 49:367–70.PubMedCrossRef

5.Daniels D, Grytdal S, Wasley A. Centers for Disease Control and prevention (CDC). Surveillance for acute viral hepatitis—United States, 2007. MMWR Surveill Summ. 2009; 58:1.PubMed