HEPATITIS A RATES UP FOR LATINO KIDS.

Byline: Lisa M. Sodders Staff Writer

Hepatitis A rates among Latino children in Southern California have reached epidemic levels, with those youngsters six times more likely to contract the virus than non-Latinos, according to a study released Tuesday.

The University of California at Los Angeles' Center for the Study of Latino Health and Culture looked at hepatitis A rates among 2.3 million Latino children in Los Angeles, Riverside, Orange, San Bernardino and San Diego counties from 1996 to 2000.

Latino children in the five-county area have an average infection rate of 36 per 100,000, which is 80 percent higher than the threshold rate at which the U.S. Centers for Disease Control and Prevention recommends vaccinations. The threshold rate is 20 cases per 100,000.

``It's hard to think of any other major public health problem that can be so easily prevented among Latino children as hepatitis A,'' said David E. Hayes-Bautista, director of the center and principal author of the study, which was funded by GlaxoSmithKline, which makes a hepatitis A vaccine.

Researchers said their concern extended to the entire community because Latinos make up such a large proportion of food-handling workers and the disease is infectious.

Hepatitis A is a viral infection of the liver. Symptoms include fever, malaise, anorexia, nausea, dark urine and jaundice, but in some cases, particularly in children, the symptoms are not noticeable.

The virus is spread by household or sexual contact with an infected person or by eating contaminated food or by drinking contaminated water. It also can be spread by the fecal-oral route: an adult could become infected after changing the diaper of an infected child and then failing to wash his or her hands.

Hepatitis A can be prevented by vaccination, which would reduce public spending for treatment, lost school days for children and reduce the risk of the virus spreading to non-Latino populations, according to the study.

Los Angeles County, which has the largest number of Latino children among the five counties studied, had a rate of nearly 34 per 100,000. The highest rate of hepatitis A was found in Riverside County, where statistics found 51 cases per 100,000.

The problem could well extend beyond the Latino community, Hayes- Bautista said. Food handlers in Los Angeles County are predominantly Latino - 53.7 percent, according to the study. These food handlers often work in higher-income, non-Latino areas of the country.

``I wouldn't say, Don't eat out, but we suspect there could be a risk and we need to keep an eye on it,'' Hayes-Bautista said.

But a Los Angeles County Health Department official said adult food- handlers might not necessarily pose a risk.

``Hepatitis A, generally speaking, is a common infection,'' said Mike Tormey, an epidemiologist with the Los Angeles County Health Department, Acute Communicable Disease Control.

``Maybe 20, 30 years ago, half the adult population (nationwide) would have had evidence of hepatitis A antibodies,'' Tormey said. Thanks to improved health and sanitation in the United States, that has changed, but levels in Mexico remain high.

Many adult Latinos are already immune because they had the virus when they were very young, Tormey said. Someone who gets hepatitis A won't get it again and isn't a risk to transmit the virus once he or she is well. But he agreed that vaccination for children is important.

``Over the past few years we've been trying to get legislation, not just in L.A. County but statewide, to require hepatitis A vaccines for children entering kindergarten and preschool,'' Tormey said.

Hepatitis A vaccines are not mandatory for schoolchildren, but parents can get them for their children at county immunization clinics, he said.

Hayes-Bautista also noted that studies have shown that almost 89 percent of Latino children in Los Angeles were born in the United States, making the high hepatitis rate not an immigration issue, but one for Californians.

``Hepatitis A in Latino children is a domestic issue, involving young U.S. citizens, and it requires a domestic solution,'' Hayes-Bautista said.

``Unlike (hepatitis) B or C, which can live chronically in the liver and cause longer-term effects, hepatitis A doesn't do that,'' said Dr. Arthur Gomez, associate program director for the UCLA San Fernando Program in internal medicine at Sepulveda VA Hospital and Olive View Medical Center.

``A is more self-limiting; the danger is during the acute infection.''

Because hepatitis A is caused by a virus, treatment consists of addressing the symptoms, including diarrhea and dehydration, Gomez said.

In very rare cases, the patient can develop fulminant hepatitis, which can lead to significant liver damage, but for the most part, doctors just treat the symptoms and advise parents to take extra precautions with hygiene to prevent the virus from spreading, he said.

Karen Maiorca, director of nursing for the Los Angeles Unified School District, said the 722,000-pupil district reported only 17 cases of hepatitis A since July 1, 2001. In comparison, there were more than 120 cases of chicken pox.

The study found that the health care costs of hepatitis A, however, can be high. Of the 291 Latino children who were hospitalized with hepatitis A during the study period - out of a total of 4,094 cases - the average hospitalization cost per case was $14,400.

CAPTION(S):

chart

Chart:

THE HEPATITIS A BURDEN

SOURCE: UCLA

Daily News