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7. Hepatitis A Incidence, 1980-2002

So, hepatitis A: hepatitis A is actually the kind of thing we like to see - many people may not realize, but we have had almost a stellar success. You get a vaccine out there and this disease starts to go away. You may argue that we had all these cycles up and it is just one of the downturns that naturally occur. But what has happened is that hepatitis A has fallen below any of the historic lows that have occurred when it was naturally circulating, and there have been studies done that show that this is being driven by immunization. This yellow line up here that occurs on several slides is the Healthy People 2010 target. We have actually done better than the target. But even with rates of about 2 per 100,000 population, this still means that we are getting reported upwards of 10,000 cases. As I showed you earlier that still represents almost 90,000 infected people, and one of the problems with viral hepatitis is that many infections are asymptomatic, and zero is not always zero. That is going to become a problem as we get farther into control, but I think we can all deal with that, and again that is part of figuring out how best to approach these diseases.