More than 30 percent of cases involve children under age 15. Schaffner said hepatitis A is found in the intestinal tract and fecal matter and is spread from person to person through fecal-oral transmission. One common way is small children who fail to wash their hands after using the bathroom and pass the virus to other youngsters, who take it home and spread it among family members. Although the child showed only flu symptoms, Waldman said her doctor advised her to take him to a hospital emergency department for tests. Schaffner said sometimes hepatitis A, which affects the liver, may often show itself through flu-like symptoms, so many victims aren't aware they've contracted the virus.
More serious cases have the more pronounced and common symptom of a yellowing of the skin and eyes.
Hepatitis A also can be spread through food and water contamination. She ate the strawberries during a school lunch. The incubation period was very long. The current recommendation is the second phase of a three-prong hepatitis A program. Two years ago, the first phase included a recommendation for vaccinations of adults who travel internationally and residents of small, ethnic communities, such as Indian reservations.