Tag: hepatitis A outbreaks

How to Avoid a Quarantine During an Outbreak at Your School

Believe it or not, hundreds of kids get caught up in quarantines for vaccine-preventable diseases in the United States each year.

Quarantines were routine in the pre-vaccine era.
Quarantines were routine during pre-vaccine era epidemics.

Wait, what?

Caught up in quarantines for vaccine-preventable diseases?

Then why do we have vaccines?

How to Avoid a Quarantine During an Outbreak at Your School

Is it fair that unvaccinated students need to stay home when there is an outbreak of a vaccine-preventable disease?
Is it fair that unvaccinated students need to stay home when there is an outbreak of a vaccine-preventable disease?

As you have probably already guessed, these aren’t usually vaccinated kids that are getting sick or quarantined in these outbreaks of measles, meningococcemia, and chicken pox, etc.

That’s right, they are unvaccinated.

Typically intentionally unvaccinated, although they are sometimes too young to be vaccinated or may have a medical exemption.

And that brings up to a few very easy ways to avoid getting quarantined during an outbreak:

  1. make sure you are always up-to-date on all of your vaccines
  2. if you think that you have natural immunity (already had the disease) or were vaccinated, but don’t have your immunization records, then getting a titer test might keep you out of quarantine if you can prove that you are immune
  3. get vaccinated, if possible, at the first sign of the outbreak, which might help you avoid quarantine in the case of measles and chicken pox

“Persons who continue to be exempted from or who refuse measles vaccination should be excluded from the school, child care, or other institutions until 21 days after rash onset in the last case of measles.”

Manual for the Surveillance of Vaccine-Preventable Diseases

That’s right, especially in the case of measles, you can often avoid being quarantined if you simply get vaccinated.

Unvaccinated children exposed to measles are quarantined for at least 21 days.
Unvaccinated children exposed to measles are typically quarantined for at least 21 days.

Why are quarantines important?

Can’t you just isolate yourself if you get sick?

The problem with that strategy is that you are often contagious before you develop symptoms. That’s especially true of measles, when you likely won’t even realize that you have measles until you get the measles rash, after having a high fever for three to five days. That’s why people with measles are often seen at clinics and emergency rooms multiple times, exposing many people, before they are finally diagnosed. It is the classic signs of a rash with continued fever that helps to make the diagnosis.

Without quarantines of unvaccinated people, especially those who are known exposures to other cases, today’s outbreaks would be even bigger and harder to control.

If you don’t want to take the risk of being quarantined and missing weeks or months of school or work, then don’t take the risk of being unvaccinated. Tragically, that’s not the only risk you take when you skip or delay your vaccines. In addition to getting sick, you also risk getting others sick, including those who didn’t have a choice about getting vaccinated yet.

What to Know About Avoiding Quarantines During an Outbreak

The easiest way to avoid getting caught up in a quarantine for a vaccine-preventable disease is to simply make sure your kids are up-to-date on all of their vaccines.

More on Avoiding Quarantines During an Outbreak

 

What to Do If Your Child Is Exposed to Hepatitis A

Hepatitis A is a vaccine preventable disease.

The hepatitis A vaccine was first added to the immunization schedule in 1996, but wasn’t made a universal recommendation for all children until 2006. At first, it was just given to high risk kids.

Now all toddlers begin to get a two dose hepatitis A vaccine series beginning when they are 1 to 2 years old, with 6 to 18 months between the doses.

Unfortunately, unlike many other vaccines, there was never a catch-up plan for those who were unvaccinated, so some teens and many adults are still not vaccinated and still not protected against hepatitis A infections.

Getting Exposed to Hepatitis A

How do you get hepatitis A?

“The hepatitis A virus is able to survive outside the body for months. High temperatures, such as boiling or cooking food or liquids for at least 1 minute at 185°F (85°C), kill the virus, although freezing temperatures do not.”

CDC on Hepatitis A Questions and Answers

Unlike hepatitis B, which is spread through blood and body fluids, people who are infected with hepatitis A shed the virus in their stool.

So you can get infected by having close contact with someone who has hepatitis A or by eating or drinking contaminated food or water.

How do you know if you have been exposed?

While an employee in the produce department at a Kroger in Kentucky recently exposed folks to hepatitis A, back in 2016 it was a Whole Foods in Michigan that was linked to an outbreak.
While an employee in the produce department at a Kroger in Kentucky recently exposed folks to hepatitis A, back in 2016 it was a Whole Foods in Michigan that was linked to an outbreak.

Exposures are most common in local common-source outbreaks caused by sick food handlers at restaurants and grocery stores and multi-state hepatitis A outbreaks caused by contaminated foods. These types of exposures are usually announced by your local or state health department.

Other exposures occur if you are living with someone who develops hepatitis A or travel to a country where hepatitis A is still common.

What to Do If Your Unvaccinated Child Is Exposed to Hepatitis A

If your unvaccinated child is exposed to hepatitis A, you should talk to your pediatrician or local health department about starting post-exposure prophylaxis as soon as possible and not longer than 14 days, including either:

  • the first dose of hepatitis A vaccine, with plans to get the second dose of vaccine in 6 months, or
  • a dose of immune globulin (provides a passive transfer of antibodies)

In general, getting the hepatitis A vaccine is preferred over getting immune globulin for most healthy people between 12 months and 40 years of age. For infants less than 12 months (too young to be vaccinated) and unvaccinated adults over age 40 years, immune globulin is preferred after an exposure to hepatitis A.

Immune globulin is also preferred for anyone who is immunocompromised or chronic liver disease.

What if it has been more than 14 days since the exposure?

While it is likely too late for immune globulin, your unvaccinated child should still likely get a dose of hepatitis A vaccine to protect against future exposures. And watch carefully over the next 15 to 50 days (the incubation period) for symptoms of hepatitis A, which can include jaundice, fever, and vomiting, etc. Many children don’t have symptoms though, so your child could develop hepatitis A, and be contagious and expose others without your even knowing it.

If post-exposure vaccination works, can’t you just wait until your child is exposed to get vaccinated? That might work – if you could be sure about each and every exposure that your child will ever have. Since that’s not possible, don’t delay getting vaccinated and put your child at risk of getting hepatitis A.

What to Do If Your Vaccinated Child Is Exposed to Hepatitis A

The hepatitis A vaccine is very effective.

One dose provide 95% protection against hepatitis A infections and the second dose boosts the efficacy rate up to 99%.

If your child is partially vaccinated, with just one dose and has been exposed to hepatitis A, get the second dose if it has been at least six months since he was vaccinated. Otherwise, talk to your pediatrician or local health department, but your child is likely considered protected.

What to Know About Getting Exposed to Hepatitis A

Learn what to do if your child is exposed to hepatitis A, especially if they aren’t already vaccinated and protected.

More on Getting Exposed to Hepatitis A