Viral hepatitis.

Author:Breckenridge, Robert, II

Prevention and control in correctional settings

On Saturday, Aug. 3, health care practitioners and corrections professionals gathered at the Hynes Convention Center, Ballroom A, for the Health Care Special Session and Luncheon, sponsored by Centurion, LLC. As attendees enjoyed a delicious meal, they were also treated to valuable information about an emerging problem in corrections.

This year's session covered the growing concern of viral hepatitis A (HAV), B (HBV) and C (HCV) in correctional settings. The American Correctional Association brought in one of the best in the field, Dr. Noele Nelson, M.D., Ph.D., M.P.H., to give a keynote lecture on this emerging issue. Dr. Nelson is the Branch Chief for the Prevention Branch, Division of Viral Hepatitis for the Centers for Disease Control (CDC). She is responsible for overseeing national efforts to test, implement and monitor HBV and HCV screenings, linkage to care and treatment interventions and perinatal HBV and HCV prevention. In addition, Dr. Nelson focuses on HAV and HBV vaccine recommendation development as the CDC Advisory Committee on Immunization Practices (ACIP) work group lead. She earned a master's in Public Heath in 1996, an M.D. from the Medical School for International Health in 2004, and a Ph.D. from Ben Gurion University in Epidemiology.

Hepatitis A

Dr. Nelson started her lecture with the hepatitis A infection, which was first reported in 1966. Reported cases of HAV dropped dramatically after its discovery due to improvement in hygiene and in water supplies. The HAV vaccine was introduced in 1996, further dropping the reported rate of infections until 2011, when cases involving adults started to increase. Dr. Nelson informed the crowd that persons in the age range of 20-59 are the most affected, with 20-29-year-old persons twice as likely to be infected. In total, the HAV outbreak is in more than 25 states, with 22,295 total cases, 13,184 hospitalizations (60% of those infected are hospitalized) and 216 deaths, according to the CDC. Many factors go into the reported deaths of those with HAV, including poor underlying health conditions and the severity of the infection increasing with age. Co-infections with HBV and HCV are also contributing factors to consider. Many of the cases driving this outbreak are people who use drugs or experience homelessness, due to person-to-person contact, overcrowding and poor hygiene. Dr. Nelson then explained how hepatitis infections can spread...

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