37. Group B Streptococcus

DIAGNOSIS Anti-HAV IgM is the diagnostic criterion for acute hepatitis A virus (HAV) infection. SYMPTOMS Fever, malaise, decreased appetite, nausea, abdominal discomfort, dark urine, jaundice. EPIDEMIOLOGY/INCIDENCE Hepatitis A infection is seen in <1/1000 pregnancies [1]. Worldwide, geographic areas can be characterized by high, intermediate, or low levels of endemicity (Figure 29.1). Levels of endemicity are related to hygienic and sanitary conditions in the geographic areas. HAV infection is common (high or intermediate endemicity) throughout the developing world, where infections most frequently are acquired during early childhood and usually are asymptomatic or mild. In areas of high endemicity, adults are usually immune and epidemics of hepatitis A are uncommon.