Epidemics of jaundice have been reported for many centuries and the term 'infectious hepatitis' was coined in 1912 to describe these outbreaks. The term 'hepatitis type A' was adopted by the World Health Organization (WHO) in 1973 to describe this form of hepatitis, and the virus was visualised by electron microscopy in human faecal extracts in the same year. Hepatitis A virus (HAV) is spread by the faecal-oral route. It remains endemic throughout the world and is hyperendemic in areas with poor standards of sanitation and hygiene. Since the end of World War II in 1945, the seroprevalence of antibodies to HAV has declined in many countries. Infection results most commonly from person-to-person contact, but large epidemics do occur. For example, in 1988, an outbreak of hepatitis A associated with the consumption of raw clams in Shanghai resulted in almost 300 000 cases.
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