Rise in the Incidence of Viral Hepatitis in Israel Despite Improved Socioeconomic Conditions

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Abstract
The incidence of viral hepatitis (mostly type A) in Israel, an area highly endemic for the disease, was examined between 1951 and 1985. During a period of improved standards of living, the overall reported incidence of the disease increased. In the Jewish population, the age of peak incidence shifted from 1–4 y to 5–9 y; this change is compatible with improved sanitation. However, whereas the absolute incidence declined among children 1–4 y old, it doubled among those 5–9 y old over the same period. The peak incidence in the non-Jewish population remains in children 1–4 y old. One possible explanation for the rise in overall incidence is an increase in the ratio of clinical to subclinical infections due to a shift of peak incidence to an older age group. Seasonal patterns have persisted against a background of changing morbidity, with the maximal incidence from late summer to midwinter. An unexplained, consistent excess incidence among males is observed for all age groups.

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