These children usually remain undiagnosed but are just as contagious. The period of greatest infectivity is 1-2 days before onset of jaundice. May return to school as soon as fever and jaundice are gone and appetite has returned. Immune globulin is protective if given within 10-14 days of exposure. Exposure at regular school is not considered a close contact and therefore IG is not recommended except under unusual circumstances.
Active immunization is now available and effective.
Drug users sharing needles, promiscuous sexual contact. Carrier state may be accompanied by chronic liver infection leading to cirrhosis or cancer. Carriers are just as contagious as active cases. Active immunization available and effective. Most school personnel are not at high enough risk to warrant active immunization.