Avoiding hepatitis A.

If you're worried about contracting hepatitis A from eating shrimp salad at an exotic Caribbean resort--as a recent national magazine ad suggests--don't be, say the Centers for Disease Control and Prevention (CDC). According to CDC estimates, the most likely locales for the disease are South America, Africa, Asia, and the Middle East.

Unlike hepatitis B or C, hepatitis A can also occur when one drinks contaminated water or shakes hands. Though seldom deadly, hepatitis A can lurk for months, causing fever, fatigue, and nausea. The biggest risk, says Dr. Harold Margolis, chief of the CDC's hepatitis branch, is person-to-person contact, especially with young children, who can carry the disease without showing any symptoms.

Although it is possible to obtain the disease from eating any food, the traveler to foreign lands can go around the problem by obtaining a vaccine now available at most hospitals and travel-medicine clinics. Getting a booster shot six months later enables the vaccine to last for a lifetime. Two companies make the virus: SmithKline Beecham, which manufactures its product under the name HAVRIX, and Merck & Company, which calls its product VAQTA. No adverse effects have been attributed to either version of the vaccine, and the most frequently reported side effect has been that of soreness at the injection site. Other vaccines can be given simultaneously with HAVRIX or VAQTA, but at a different injection site.

Children in communities that have high rates of hepatitis A and periodic hepatitis A outbreaks, such as various American Indian and native Alaskan tribes, should be routinely vaccinated beginning at age two. Because of the limited experience with the hepatitis A vaccine among children younger than age two, the FDA has not licensed the vaccine for this age group.

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