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暴发性甲型肝炎
原作者: Andrea Tenner, 肖锋译 发布日期:2013-08-01

Title: Hepatitis A Outbreak
题目:暴发性甲型肝炎
Author 作者: Andrea Tenner

General Information 一般资料:
Hepatitis A is a food-borne illness that is prevalent in developing countries.  Currently in the US we are experiencing an outbreak in 8 states related to a frozen blend of organic berries. (Linked to Townson Farms brand sold at Costco and Harris Teeter)
甲型肝炎是一种食源性疾病,多见于发展中国家。目前在美国,我们正在经历一个在8个州由速冻混合有机莓果造成的爆发。 (在Costco和哈里斯蒂特销售的Townson农场品牌)
Clinical Presentation 临床表现:
- Case definition: sudden onset of S/S + jaundice or elevated liver enzyme levels
- 病例定义:突然发作的症状和体征加上黄疸或肝脏酶谱水平升高
- S/S: nausea, anorexia, fever, malaise, abdominal pain
- 症状和体征:恶心,食欲不振,发热,全身乏力,腹痛
Diagnosis 诊断:
- Hepatitis A IgM
- A型肝炎IgM抗体
Treatment 治疗方法:
- Exposed patients should be given the Hep A vaccine within 2 weeks of exposure
- 有接触的患者应在2周内给予甲肝疫苗
- Exposed patients >40 yrs old, <1 yr old, immunocompromised, or with chronic liver disease: give immunoglobulin instead (risk of more severe disease)
- 有接触的患者如> 40岁,<1岁,免疫功能低下,或患有慢性肝病:要给予免疫球蛋白(出现严重疾病的危险高)
- Supportive care 支持治疗
Bottom Line 要点:
Patients potentially exposed to Hepatitis A in the past 2 weeks should be given either the vaccination or immunoglobulin, depending on comorbid conditions.  Treatment of active infection is supportive.
在两周内接触甲型肝炎的患者应根据并发症的情况接种疫苗或免疫球蛋白。活动性感染的治疗主要是支持性的。
References 参考文献:
http://www.cdc.gov/hepatitis/HAV/HAVfaq.htm#general
http://www.cdc.gov/hepatitis/Outbreaks/2013/A1b-03-31/index.html