Primary school child with hepatitis A - containment measures

A primary school kid in Halle has contracted hepatitis A, sparking efforts to halt any further infections. The family of the sick child has been given a so-called lockdown vaccination, and the affected class will continue homeschooling until the winter break on December 20, as announced by the city.

Over forty children and four adults have been identified as potential contacts, prompting pediatric practices in the area to prepare for an uptick in hepatitis A vaccination requests.

Hepatitis A, a notifiable infectious disease, can be contracted through direct contact, smear infection (like shared use of facilities), or consumption of contaminated food, water, or utensils. Symptoms typically include nausea, vomiting, abdominal pain, a general sense of unwellness, fever, jaundice, pale stools, and dark urine. Most patients recover fully within two to three months.

Fortunately, hepatitis A cases in Halle are relatively uncommon, with only nine recorded in 2022 and five so far in 2023.

In the wake of this situation, it's crucial to emphasize hygiene practices, such as regular handwashing, and implement preventative measures to limit the spread of hepatitis A.

Big picture: In response to the confirmed hepatitis A case at a primary school, the affected class is undergoing homeschooling as a containment strategy. This incident has sparked an increased demand for hepatitis A vaccinations in local pediatric practices in Saxony-Anhalt. A total of 45 potential contacts have been identified and vaccination recommendations have been issued for those who have not been previously immunized.

Further Reading:

To contain the spread of hepatitis A in a school setting, the following steps should be implemented:

1. Identify close contacts:
   • Determine all individuals who have had close contact with the confirmed case, including their classmates, other school years, and shared toilet and hand washing facilities.
2. Risk assessment:
   • Perform a risk assessment to determine if a small group at risk can be identified (such as close friends of the index case), requiring targeted vaccination, or if wider immunization in the same class, year, or entire school is necessary.
3. Hygiene measures:
   • Strengthen hygiene practices among students and staff, including vigorous hand washing before preparing or eating food, after using the bathroom, and after sexual activity. Encourage the use of protection during sexual intercourse and never sharing sex toys.
4. Vaccination:
   • Offer the hepatitis A vaccine to all identified close contacts who have not previously been vaccinated. If the vaccine cannot be given within 14 days of exposure, administer to the entire class or school if necessary. Offer vaccine to those at high risk of severe disease, even if they do not meet the close contact criteria, to curb further transmission.
5. Human immune globulin (HNIG):
   • If needed, offer HNIG (immune globulin) to those at high risk of severe disease who meet the close contact criteria after assessing individual risk.
6. Community communications:
   • Ensure effective communication and social mobilization within the community to achieve appropriate vaccine coverage and halt transmission.
7. Infection prevention and control:
   • Provide advice and support for enhanced environmental cleaning and hand washing during an outbreak.

By implementing these measures, the spread of hepatitis A in a school setting can be effectively limited.