A hearty thanks to Flea for his shout-out today welcoming me to the blogosphere. Lately he's been running a great series on vaccine-preventable diseases. And he's also nominated for the 2006 Medical Weblog Awards (I've yet to check out all of the nominees, but I can assure you he's in good company). Of course, you probably already knew this since there is a good chance you came across my blog via his.
Speaking of vaccine-preventable diseases, yesterday I saw a child with what is most likely Hepatitis A. If it is, that's good, because it's a self-limited virus that just runs its course--for her. Her family and preschool face a different situation, with vaccine and immune globulin shots all around.
HepA is widespread in the west and southwest, but relatively rare here. In fact, I think this is the first case I've seen in seven years. I talked to a Pedi Gastroenterologist in New Orleans who confirmed he hasn't seen much either.
Just last year the immunization schedule was updated, recommending Hepatitis A shots for all kids 12-24 months. Prior to that, it had been just for children in high-risk areas. This is one of those indirect vaccination strategies, since infants and toddlers usually don't get sick or have severe symptoms, but the older kids and adults are the ones that end up suffering (and even face a risk of fulminant liver failure). The toddlers share and spread the disease, so you vaccinate them to protect the older folks. I can't comment on the public health costs and benefits of universal vaccination in term of dollars and cents, but I think it's fair to say that this one case is probably going to cause a lot of worry and work for a lot of people around here.