Hepatitis A at Jam Band Concerts Alert (cont.)
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Public Health Dispatch: Multistate Outbreak of Hepatitis A Among Young Adult Concert Attendees --- United States, 2003
In July 2003, a cluster of hepatitis A cases was identified among young adults who had attended outdoor concert and camping events featuring various "jam bands." As of September 2, a total of 25 cases have been reported among residents of nine states (Arizona, California, Colorado, Indiana, Michigan, New York, Oregon, Tennessee, and Wisconsin). The majority of cases were among young adults who attended concerts during the spring and summer. The median age of infected persons was 23 years (range: 17--44 years); 14 (56%) were male.
The bands performing at these concerts and festivals attract fans who travel from one concert to another, sometimes continuously over several months. Concerts often are multiday events involving camping on established or impromptu campgrounds, and sanitary conditions sometimes are poor. Unofficial food vendors are common at these events, and many are concert attendees. Attendance at the events has ranged from 1,200 to 82,000 persons. At large outdoor gatherings, crowded conditions, a lack of hand-washing facilities, and poor sanitation might contribute to the potential for disease transmission (1,2).
Epidemiologic and laboratory investigations are under way to identify potential sources of hepatitis A virus infection and modes of transmission. Several patients have reported close contact with other ill patients during the incubation period, suggesting that person-to-person transmission might play an important role in the spread of the infection. On the basis of early findings in this investigation, vaccination and education campaigns were held at two recent concert events. Approximately 300 attendees were vaccinated, and several contacts were administered postexposure prophylaxis.
The three bands that infected persons most commonly followed completed their summer concert tours in early August. However, fall tours are scheduled to begin in September. Concert attendees are advised to wash their hands frequently with soap and water, particularly after using the bathroom and before eating; to cook their food and drink only potable water; and to avoid food or drugs that could have been prepared under unsanitary conditions or handled by an infected person.
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