VIRAL HEPATITIS: DESCRIPTIVE EPIDEMIOLOGY BASED ON MORBIDITY AND MORTALITY STATISTICS

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Abstract
Viral hepatitis, comprising infectious hepatitis and/or serum hepatitis, has been known in the United States for at least 100 years, but the history of the disease on a nationwide scope has not previously been described. Reported case data for the United States for 1952-1954 and recorded deaths from infectious hepatitis for 1949-1953 were used in this paper as a basis for the following inferences concerning epidemiologic characteristics of this double . entity. Reported cases have increased during the 4 years under study, with peak incidence in late winter or early spring in all regions of the United States. The seasonal low has consistently occurred in summer here as well as in the Scandinavian countries and in England. This cyclic behavior emphasizes the epidemic nature of infectious hepatitis. Seasonal distribution of recorded deaths in this country, however, shows little variation during the year, suggesting that deaths may be due mainly to serum hepatitis. A geographic classification of reported case data by state and region of the United States by year suggests that there has been an actual increase in incidence of the disease, along with improvement in reporting of cases. Age and sex data indicate that highest incidence occurs in age groups under 15 years, and that both sexes are equally susceptible to the disease. Mortality data show increase in higher rates with increasing age, indicating that hepatitis is more severe in older age groups, or that incidence increases in these age groups. Analysis of these mortality data by age and sex shows an excess of female deaths in the age groups extending from the menarche through the menopause, and an excess of male deaths in age groups over 50 years. The reasons for these differences are not apparent.

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