Who should get hepatitis vaccines?

Hundreds of people in Polk County may have been exposed to hepatitis A through tainted food at a church cookout and three different restaurants. One elderly woman with the disease died in March; an Auburndale man required a liver transplant.

Although experts say such clusters are extremely rare, the more than 100 confirmed cases in the county this year raise the question: Should everyone be routinely vaccinated against hepatitis?

At the least, its flulike symptoms can be miserable. At worst, it can cause liver failure and even death.

"I think a case could be made, not for Polk County but for the entire country, that this vaccine should be more widely used," says Dr. John Sinnott, director of infectious diseases at the University of South Florida and Tampa General Hospital.

The Centers for Disease Control and Prevention recommends vaccination only for high-risk groups: people with chronic liver disease or blood clotting disorders requiring transfusions, men who have sex with men, and users who share injected or inhaled street drugs.

Medical workers also are often vaccinated. People traveling outside the United States and northern Europe to areas where the disease is more prevalent should be, too, experts recommend.

Hepatitis is a liver disease. There are five different types: A, B, C, D and E. The cases in Polk are hepatitis A, which is not considered life-threatening. Hepatitis A is typically transmitted by drinking or eating infected fecal matter. For example, failure to adequately wash hands with soap after using the bathroom or before preparing food can spread the disease, as is indicated in the Polk County cases.

If exposure is already suspected, an injection of immune globulin within 14 days provides about three months' protection.

Florida public schools require hepatitis B vaccinations for entering seventh-graders. Yet adults rarely consider shots for themselves. Last May the Food and Drug Administration licensed a combined hepatitis A and B vaccine for those 18 and older, to be given in three doses over six months. The protection lasts up to 10 years.

"You could eradicate a great deal of hepatitis" with the vaccinations, Sinnott says.

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