The disease spreads easily within families, child care facilities, schools and overcrowded areas.
Hispanic children show the highest rates of infection in Texas.
Contaminated water leads to high rates of hepatitis in Texas-Mexico border communities. In Public Health Region 11, a 19-county area of South Texas, hepatitis strikes 61 of every 100,000 residents more than double the statewide rate. Federal and state vaccination programs are in place to combat some strains of the disease. A 1995 state law requires hepatitis B vaccination for all elementary and secondary school children in Texas. Effective later this year, all children age 5 and older must have three doses of hepatitis B vaccine.