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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors' clinical recommendations.
A 34-year-old man presented to the emergency department two weeks after returning from a trip to India, reporting a six-day history of anorexia, vomiting, malaise, fatigue, and dark urine. His alanine aminotransferase level was 7330 U per liter, the bilirubin level was 8 mg per deciliter (137 µmol per liter), and a test of the serum for hepatitis A IgM antibodies was
The Clinical and Public Health Problems
Strategies and Evidence
Hepatitis A Vaccine
Strategies for the Use of Hepatitis A Vaccine
Immune Globulin for Passive Immunoprophylaxis
Areas of Uncertainty
Guidelines
Conclusions and Recommendations
Source Information
From the Communicable and Environmental Disease Services Section, Tennessee Department of Health (A.S.C.); and the Department of Preventive Medicine, Vanderbilt University School of Medicine (W.S.) both in Nashville.
Address reprint requests to Dr. Schaffner at the Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, or at william.schaffner@vanderbilt.edu.
Related Letters:
Hepatitis A Vaccine
Van Herck K., Van Damme P., Rosenthal P., Craig A. S., Schaffner W.
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N Engl J Med 2004;
350:2211-2212, May 20, 2004.
Correspondence
This article has been cited by other articles:
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