Epidemiological Study of Hepatitis A Infection in Eastern Bulgaria

Abstract

Background: Hepatitis A virus (HAV) infection is an acute, self-limited liver disease transmitted usually through the faecal-oral route via person-to-person contact. Bulgaria has intermediate HAV endemicity with higher susceptibility among adults and recurrent outbreaks. Aim: As HAV infection is strongly related to human movements and represents a significant risk to travelers and migrants, as well as to local population receiving these groups, we set out to analyze the epidemiological data on hepatitis A in five of the largest tourist border regions of Bulgaria located in its eastern part: Varna, Shumen, Dobrich, Burgas and Yambol. Materials and methods: We reviewed retrospectively all reported cases of acute hepatitis A in the eastern regions of Bulgaria over a 7-year period between 2008 and 2014. Results: A total of 2879 newly infected patients were registered during the study period, the number varying widely: from 190 cases in 2014 to 923 in 2012. The average incidence of HAV was higher in the south-eastern regions than in the northeastern regions (55.30%000 vs 15.04%000 respectively, p < 0.0001). The most affected age group in all regions was the 5-9-year olds (p < 0.0001) and males were significantly more susceptible to HAV (p = 0.02). Conclusion: Hepatitis A is still a major public health problem in Bulgaria; there is a significant difference in the incidence of the disease between the regions in the south-east and those in the north-east and between the different age groups and sexes.

Enterically transmitted hepatitis in the third millennium in northeastern Romania

“…Tsankova et al found in Bulgaria recurrent outbreaks with time and geographic fluctuations. Similar with our data, male gender and children aged less than 9 years are the main risk factors associated with spread of the disease (20).…”

“…In one report, for example, 213 cases of hepatitis A were detected in 23 schools in Michigan and 29 cases in 13 schools in Maine; all were related to contaminated frozen strawberries from a common source (18). The epidemiological characteristics of HAV disease recorded in our study are in line with other Southeastern European countries (19,20). Tsankova et al found in Bulgaria recurrent outbreaks with time and geographic fluctuations.…”

Involvement of the gallbladder in the course of viral hepatitis A in childhood

“…2 The course of AHA is usually mild and self-limiting, often asymptomatic, and hepato-protective maintenance treatment is sufficient. 3,4 In a large number of patients, especially children, jaundice is the only symptom for which medical advice is sought. Rare complications such as oedema, long-lasting jaundice and acute liver failure 5,6 have been described.…”