Global Patterns of Hepatitis a virus Transmission Disease Peak Age Endemicity Rate of Infection Transmission Patterns High Early Person to person; High childhood outbreaks uncommon Moderate High ate Person to person childhood/ food and waterborne young adults outbreaks Low Low Young adults Person to person food and waterborne outbreaks Very low Very low Adults Travelers; outbreaks uncommonEndemicity Disease Rate Peak Age of Infection Transmission Patterns High Low to High Early childhood Person to person; outbreaks uncommon Moderate High Late childhood/ young adults Person to person; food and waterborne outbreaks Low Low Young adults Person to person; food and waterborne outbreaks Very low Very low Adults Travelers; outbreaks uncommon Global Patterns of Hepatitis A Virus Transmission