Hepatitis A,B, and C in Canada. Results from the National Sentinel Health Unit Surveillance System, 1993-1995

OBJECTIVES: To estimate the incidence of and to describe the risk factors that were associated with the acquisition of hepatitis A, B, and C in well-defined Canadian populations from the Sentinel Health Unit Surveillance System (SHUSS). METHODS: We used the 1993 to 1995 data on hepatitis A, B, and C infection in Canada, collected by SHUSS, a national surveillance system established by the Laboratory Centre for Disease Control in Health Canada in 1993, through consultation and collaboration with provincial partners. We calculated the rates of, and described and discussed the risk factors that were associated with, hepatitis A, B, and C infection, based on the SHUSS surveillance data. RESULTS: From 1993 to 1995, SHUSS reported 92 cases of hepatitis A, 89 hepatitis B, and 720 hepatitis C, yielding a rate of 3.9, 3.8, and 30.3 per 100,000, respectively. The reported rates varied substantially among participating health units, ranging from 0.8 to 8.1 per 100,000 for hepatitis A, 0.0 to 9.0 for hepatitis B, and 5.4 to 73.3 for hepatitis C. The most frequently reported risk factor for hepatitis A was a history of street drug use, followed by recent international travel and household contact with a hepatitis A case, household crowding, and a history of raw or undercooked shellfish consumption. The most frequently reported risk factors for the acquisition of hepatitis B included history of street drug use and occupational exposure. The most frequently reported risk factor for the acquisition of hepatitis C was a history of street drug use, followed by health care exposure and occupational exposure. Only 5% of persons with hepatitis B infection had a history of hepatitis B immunization. INTERPRETATION: Despite the limitations of possible bias due to selective participation of SHUSS and the lack of information on risk factors among controls, the high exposure to known risk factors and the low rate of vaccination among hepatitis patients can provide useful information for the development of public health policies to control hepatitis A, B, and C infection in Canada.     

Prevalence of indications for adult hepatitis A vaccination among hepatitis A outbreak-associated cases,Three US States, 2016–2019

BackgroundSafe and effective hepatitis A vaccines have been recommended in the United States for at-risk adults since 1996; however, adult vaccination coverage is low.MethodsAmong a random sample of adult outbreak-associated hepatitis A cases from three states that were heavily affected by person-to-person hepatitis A outbreaks, we assessed the presence of documented Advisory Committee on Immunization Practices (ACIP) indications for hepatitis A vaccination, hepatitis A vaccination status, and whether cases that were epidemiologically linked to an outbreak-associated hepatitis A case had received postexposure prophylaxis (PEP).ResultsOverall, 74.1% of cases had a documented ACIP indication for hepatitis A vaccination. Fewer than 20% of epidemiologically linked cases received PEP.ConclusionsEfforts are needed to increase provider awareness of and adherence to ACIP childhood and adult hepatitis A vaccination and PEP recommendations in order to stop the current person-to-person hepatitis A outbreaks and prevent similar outbreaks in the future.     

中国2007～2011年甲型和戊型病毒性肝炎以及细菌性痢疾流行病学特征分析

目的比较中国2007～2011年甲型病毒性肝炎（甲肝）、戊型病毒性肝炎（戊肝）及细菌性痢疾（菌痢）的流行病学特征,为预防控制甲肝和戊肝提供参考。方法利用中国疾病预防控制信息管理系统数据,对三种疾病进行描述性流行病学分析。结果中国2007~2011年甲肝、戊肝、菌痢年平均报告发病率分别为3．74/10万、1．72/10万、21．8/10万。甲肝近40％的病例为〈15岁儿童,病例主要为农民和学生,无明显季节性;戊肝75％的病例〉40岁,病例主要为农民和离退休人员,发病2～5月居多;菌痢40％的病例为〈10岁儿童,病例主要为散居儿童和学生,发病7～9月居多。结论甲肝病例的季节性分布不明显,戊肝和菌痢仍存在明显的季节性分布。中国甲肝、菌痢发病呈明显下降趋势,主要与预防接种和卫生条件的改善有关。戊肝发病率呈上升趋势,主要与监测系统的敏感性提高有关。     

Seroprevalence survey of varicella, measles, rubella, and hepatitis A and B viruses in a multinational healthcare workforce in Saudi Arabia.

OBJECTIVE: To determine the prevalence of the vaccine-preventable diseases caused by varicella, measles, rubella, and hepatitis A and B viruses in a multinational healthcare workforce. DESIGN: Prospective cohort study. SETTING: A 750-bed tertiary care center located in Riyadh, Saudi Arabia. METHODS: In compliance with hospital policy, newly recruited healthcare workers (HCWs) were enrolled in the study from September 2001 to March 2005. Serum samples were collected from all HCWs during the initial hiring process and tested for IgG antibodies against each of the 5 viral agents. Nonimmune HCWs were subsequently vaccinated at the earliest opportunity. RESULTS: A total of 4,006 newly hired (international and local) employees were included in the study. All underwent serologic testing for IgG antibodies against varicella, measles, rubella, hepatitis A, and hepatitis B viruses. Of the total, 63% were female and 37% were male. Middle Eastern employees comprised 47% of the total, followed by employees from the Far East (35%), the West (10%), and Africa (8%). Forty-two percent were nurses, 27% were in administration, 18% were medical technicians, and 13% were physicians. Among the 4,006 newly hired HCWs, 14% had negative IgG antibody test results for varicella virus, 13% for measles virus, 10% for rubella virus, 33% for hepatitis A virus, and 43% for hepatitis B virus. More women than men were susceptible to hepatitis A (40% vs. 24%; P<.001), whereas more men were susceptible to hepatitis B (55% vs. 35%; P<.001). Varicella susceptibility was more common among HCWs from the Far East (19%), whereas susceptibility to measles, rubella, hepatitis A, and hepatitis B was highest among HCWs from the Middle East. Both relative youth and male sex were associated with lack of antibodies against hepatitis B virus and rubella virus. In contrast, female sex and younger age were associated with lack of antibodies against hepatitis A virus (P<.001). CONCLUSION: Seroprevalence surveys of vaccine-preventable diseases among HCWs, although labor intensive, are invaluable in caring for a multinational workforce.     

Commercial factor VIII associated hepatitis, 1974-75, in the United Kingdom: a retrospective survey

A retrospective survey of transfusion hepatitis associated with a brand of commercial Factor VIII was carried out in 24 Haemophilia Centres from January 1974 until December 1975. Of 371 patients who were transfused with this product, and were followed up, 78 cases of hepatitis affecting 66 patients were found (17.7%). Two types of hepatitis were observed: hepatitis B and non-B hepatitis, the latter with an incubation period of between 8 and 60 days. Twelve patients contracted two types of hepatitis, non-B followed by hepatitis B. Only one patient died after contracting hepatitis B. Four of the suspect batches of concentrate were found to be positive for HBsAg by radioimmunoassay. There was evidence that the presence of hepatitis B surface antibody in a patient's serum prior to exposure was associated with immunity to hepatitis B. Evidence was presented suggesting that the non-B hepatitis observed was not due to hepatitis A. The factors affecting the incidence of transfusion hepatitis in haemophiliacs were discussed.     

Commercial factor VIII associated hepatitis, 1974-75, in the United Kingdom: a retrospective survey.

A retrospective survey of transfusion hepatitis associated with a brand of commercial Factor VIII was carried out in 24 Haemophilia Centres from January 1974 until December 1975. Of 371 patients who were transfused with this product, and were followed up, 78 cases of hepatitis affecting 66 patients were found (17.7%). Two types of hepatitis were observed: hepatitis B and non-B hepatitis, the latter with an incubation period of between 8 and 60 days. Twelve patients contracted two types of hepatitis, non-B followed by hepatitis B. Only one patient died after contracting hepatitis B. Four of the suspect batches of concentrate were found to be positive for HBsAg by radioimmunoassay. There was evidence that the presence of hepatitis B surface antibody in a patient''s serum prior to exposure was associated with immunity to hepatitis B. Evidence was presented suggesting that the non-B hepatitis observed was not due to hepatitis A. The factors affecting the incidence of transfusion hepatitis in haemophiliacs were discussed.     

深圳市社区居民病毒性肝炎知识、态度和行为的流行病学调查

目的了解深圳社区居民对病毒性肝炎,尤其是乙肝传播、危害等相关知识的知晓率及对待乙肝感染者的态度和行为,为当地制定相关健康教育策略提供依据。方法采用流行病学现况调查方法,随机抽取深圳市15～59岁的社区居民1 544名,采用自填式问卷调查获取居民病毒性肝炎知识、态度、行为信息进行分析。结果绝大多数调查对象表示听说过甲肝(71.9%)和乙肝(91.5%),而听说过丙肝(36.6%)、丁肝(20.7%)和戊肝(18.0%)的则相对较少;仅有不到一半调查对象了解乙肝的传播途径(45.0%),但一半以上的调查对象知道可以通过疫苗接种来预防甲肝(56.9%)和乙肝(75.6%);大部分的调查对象害怕与乙肝感染者近距离接触,有30.0%和27.1%的乙肝感染者遭遇过被人远离或升学就业的困难。结论应以社区为单位,长期、持续开展形式多样的健康教育活动,提高社区人群,尤其是流动人群对病毒性肝炎的传播、预防等相关知识的认知水平,从根本上消除"乙肝恐惧"和"乙肝歧视"现象。     

2000-2014年南京市甲型病毒性肝炎流行病学分析

摘要:目的　分析2000-2014年南京市甲型病毒性肝炎（甲肝）流行特点与流行趋势,为今后的防治工作提供科学依据。方法　用描述流行病学方法对南京市2000-2014年甲肝疫情资料进行分析。结果　南京市甲肝发病率基本呈逐年下降的趋势,从2000年的5.69/10万下降到2014年的0.44/10万,地区分布上,浦口区年均发病率最高（为3.82/10万）,其次是溧水区（为2.96/10万）;从季节分布来看,全年各月均有发病,2000-2014年存在春季发病高峰;职业分布来看,发病数前3位的职业是农民、工人和干部职员;性别比为1.86∶1。从发病高峰年龄来看,2000-2004年病例以25～40岁为主,2005-2009年病例以35～45岁为主,2010-2014年病例以40～50岁年龄为主。结论　近几年来南京市甲肝报告发病率显著下降,发病年龄有后移现象,今后在进一步提高儿童甲肝疫苗接种率的同时,要做好成年人及其他重点人群的预防控制工作。     

Acute sporadic non-A, non-B hepatitis in India

A total of 293 sporadic cases of acute viral hepatitis were identified in Kashmir, India, from April 1979 to December 1981; 44 (15%) were found serologically to be hepatitis A, 94 (32%) hepatitis B, and 155 (53%) non-A, non-B type. The non-A, non-B hepatitis observed was a disease of young adults (29.8 +/- 15 years) with slight male predominance (1.4:1). Six of the 155 non-A, non-B cases had history of prior parenteral exposure, while 51 (33%) had a recent contact with another case of jaundice, suggesting that this form of hepatitis was spread by person-to-person contact. Fulminant hepatic failure occurred in 19 cases, and six (31.5%) of the 19 cases occurred in pregnant women. None of 90 non-A, non-B cases followed up six months later had developed chronic hepatitis. The acute sporadic non-A, non-B hepatitis described in Kashmir resembles epidemic non-A, non-B hepatitis epidemiologically and seems to be distinct from the non-A, non-B hepatitis described in the West.     

Increasing Burden of Acute Hepatitis A among Ethiopian Children,Adolescents, and Young adults: A Change in Epidemiological Pattern and Need for Hepatitis A Vaccine

BackgroundHepatitis A is a vaccine-preventable, feco-oral infection due to poor sanitary conditions. It is predominantly acquired during early childhood and results in lasting acquired protective immunity. However, it results in severe disease which can end up in acute fulminant hepatitis and hepatic failure when acquired during adolescence and adulthood. The prevalence of acute hepatitis A is increasing among children, adolescents, and young adults from higher-income households. They acquire this infection at a later age when they are exposed for the first time to contaminated food and drinks after being brought up in a relatively clean environment. This calls for the introduction of the Hepatitis A vaccine in Ethiopia; possibly as part of the Expanded Program on Immunization (EPI).MethodsSocio-demographic and clinical data were collected from patients who were diagnosed to have hepatitis A infection at Adera Medical Center in 2020.ResultsThis study showed that clinical acute hepatitis A is becoming common among children, adolescents, and young adults from relatively high-income families. Among patients with acute hepatitis, 89% were from middle and high-income families.ConclusionsThere is a need for the incorporation of hepatitis A vaccine in the Ethiopian EPI program.     

1999-2010年无锡市锡山区病毒性肝炎流行病学特征分析

目的探讨无锡市锡山区病毒性肝炎的流行规律,为制定防治措施提供科学依据。方法对无锡市锡山区1999-2010年报告的病毒性肝炎疫情资料进行分析。结果 1999-2010年,锡山区共报告病毒性肝炎3 204例,年平均发病率为40.19/10万。8月为发病高峰,病例以男性青壮年为主。职业分布以农民最多,工人位居第二。分型监测显示乙肝所占比重居首位,甲肝和未分型肝炎所占比重下降,丙肝和戊肝比重上升。结论锡山区病毒性肝炎发病率呈逐年下降趋势。当前控制乙肝及丙肝是降低锡山区病毒性肝炎发病的关键,加强全民健康教育,大力推广甲、乙肝疫苗仍是控制病毒性肝炎发病的主要措施。     

Effectiveness of a hepatitis A vaccination program for migrant children in Amsterdam, The Netherlands (1992-2004)

OBJECTIVE: To evaluate the impact and effectiveness of risk-group vaccination against hepatitis A targeted at migrant children living in a country with low endemicity of hepatitis A. METHODS: Retrospective population based data analysis. Routinely collected data on hepatitis A incidence in migrant children and other risk groups in Amsterdam from 1 January 1992 to 2004 were analyzed and related to exposure, immunity and vaccination coverage in migrant children. RESULTS: The overall hepatitis A incidence in Amsterdam declined after a pediatric vaccine was introduced in 1997. This decline was seen in migrant children traveling to hepatitis A-endemic countries, contacts with hepatitis A patients, primary school students, injecting drug users, and persons with unknown source of infection, but not in men who have sex with men (MSM) or in travelers to endemic countries other than migrant children. CONCLUSION: The hepatitis A vaccination campaigns are effective: they reduce both import and secondary HAV cases. The campaigns could be more efficient and cost-effective if the hepatitis B vaccinations currently given to these groups were replaced by a combined hepatitis A and B vaccine. This would increase the hepatitis A vaccination coverage considerably and further reduce the hepatitis A incidence.     

乙型肝炎患者检测HAV、HCV、HDV、HEV、HGV重叠感染在医院感染控制中意义的探讨

目的对乙型肝炎与其他型肝炎重叠感染状况分析;进一步探讨相关肝炎病毒的检测在医院感染控制中的临床意义。方法对786例乙型肝炎患者血清进行甲、丙、丁、戊、庚型肝炎血清标志物的检测。结果乙型肝炎患者双重感染占16.67%,多重感染占1.78%,尤其是与丙型肝炎的双重或多重感染占重叠感染的45.52%。结论乙型肝炎患者重叠或合并感染其他类型肝炎病毒的情况较为常见;对乙型肝炎患者做其他型肝炎标志物的检测可为医院感染诊断提供依据。     

大学生病毒性肝炎防治知识、态度、行为调查

目的 了解甘肃省在校大学生病毒性肝炎(肝炎)相关知识、态度和行为(KAP),为制定有效的肝炎防治策略和措施提供科学依据.方法 采用分层整群抽样法在甘肃省46所高校中随机抽取7所调查2 877名在校大学生,采用问卷调查的方式进行肝炎KAP及信息获取情况的调查.结果 在校大学生对主要传播途径的知晓率较低(14.15％～40.91％),对相关知识知哓率相对较高(60.38％～85.05％);得知身边的同学是乙肝病毒携带者,只有18.42％(530人)的大学生认为不会影响交往,只有29.27％(842人)的大学生认为不介意和乙肝病毒携带者共同进餐;在调查的2 877名大学生中,76.54％(2 202人)的大学生接种过乙肝疫苗,但仅有27.25％(804人)的大学生完成了全程接种;只有11.26％(324人)的大学生接种过甲肝疫苗;汉族、医学类及城市生源大学生与少数民族、非医学类及农村生源大学生在肝炎KAP比较差异有统计学意义(P＜0.01或P＜0.05).结论 在校大学生对肝炎主要传染途径知晓率较低,对其他肝炎相关知识知晓率相对较高,但对乙肝病毒携带者的排斥心理较强;大学生乙肝疫苗和甲肝疫苗接种率较低.     

天津市2000-2011年甲型肝炎免疫控制效果评价

目的：评价2000-2011年天津市甲型肝炎（甲肝）免疫控制策略实施效果。方法采用描述性方法分析天津市2000-2011年甲肝疫情,评价疫情报告和诊断的可靠性。统计甲肝免疫目标人群接种率,并以血清流行病学方法调查1999、2005和2010年健康人群甲肝抗体水平,评价免疫屏障状况。采用多重曲线模型分析天津市甲肝与其他肠道传染病的流行趋势。结果天津市历经11年在特定人群1岁幼儿、小学一年级、初中一年级学生和高危人群中实施甲肝疫苗免疫预防策略,有效控制了甲肝流行。甲肝发病率从2000年的2.89/10万降至2011年的0.12/10万;甲肝在病毒性肝炎中的比例从2000年的8.02%降到2011年的0.48%。全市甲肝抗体水平呈现随时间推移增高的趋势。结论天津市实施的甲肝疫苗免疫策略控制了甲肝流行。     

Hepatitis A, B, and delta infection in Ethiopia: a serologic survey with demographic data

A total of 500 individuals from five different regions of Ethiopia were studied. Demographic and clinical data were recorded and serologic tests were carried out to detect antigen and antibody markers of hepatitis B virus, hepatitis A virus, and the delta agent. Data on the economic status, number of rooms per household, number of persons per household, type of water supply, and mode of excreta disposal revealed that the majority of the population surveyed lived with economic hardship, overcrowding and poor hygiene. Only 36 persons gave a past history of jaundice. The mean carrier rate of hepatitis B surface antigen (HBsAg) was 6.2%, the mean overall hepatitis B virus marker prevalence was 42%, and in those over 14 years of age it was 76%. Among those who were positive for HBsAg, there was a tendency for hepatitis B e antigen (HBeAg) to decrease and the corresponding antibody (anti-HBe) to increase with advancing age. No woman more than 15 years of age had demonstrable hepatitis B e antigen in serum. Antibody to hepatitis A virus was detected in 84%. Three positive individuals were found to have antibody to the delta agent.     

Waning of anti-HAV immunity in Shijiazhuang prefecture,Hebei province,China: A comparison of seroprevalence between 1992 and 2011

Objective

To study the epidemiological patterns of hepatitis A, and immunity of entire population in Shijiazhuang prefecture, Hebei province, a former hyper-endemic area in north China.

Methods

Cross-sectional, seroprevalence surveys with two-stage cluster sampling were conducted among population older than 2-year between 1992 and 2011. During the 2011 serological survey, blood samples from infants <18 months without hepatitis A immunization history were also collected to determine maternal anti-HAV antibody. Serum samples were tested for anti-HAV antibody by domestic reagent or Abbott reagent. Viral hepatitis incidence rates and gross domestic product data were derived from local governmental statistics.

Results

Concomitant with the reduction of reported hepatitis A cases between 1992 and 1996 was a significant decline of HAV infections. The average prevalence decreased from 93.6% to 41.9%, and the average age at new infection was postponed from infancy to adolescence. This was attributed to improved socio-economic conditions. With intensive vaccination, a return of new seroconversion rate and seroprevalence was observed. A well fitted exponential regression equation (R² = 0.96, p < 0.0001) modeled that the maternal antibody would wane to <20 mIU/mL at 13 months.

Conclusion

Benefiting from the booming economy, rapid improvement in sanitation, safe water supply, and implementation of hepatitis A vaccines, the epidemiological pattern of hepatitis A moved from high to intermediate endemicity in Shijiazhuang. Policy makers should be aware of the waning of immunity in entire population, and adapt immunization strategy timely, to ensure a lifelong protection against hepatitis A virus.     

Hepatitis virus non-A, non-B: the cause of a major public health problem in India

Serological studies of hepatitis viruses A and B were carried out on 362 patients with acute viral hepatitis, 130 with fulminant hepatitis, and 56 with subacute hepatitis, and on samples of serum from 230 subjects during epidemics of viral hepatitis. A diagnosis of non-A, non-B viral hepatitis was made when serological tests showed that anti-HAV IgM and anti-HBc IgM were absent. Hepatitis virus non-A, non-B was the causative agent responsible for 58% of cases with acute viral hepatitis, 58% with fulminant hepatitis, 87% with subacute hepatitis, and 66% with epidemic hepatitis. A considerable proportion of patients (6-32%) were infected with both hepatitis virus non-A, non-B and hepatitis virus B. Viral hepatitis non-A, non-B is probably transmitted by infection of drinking-water and is the principal cause of hepatitis in India.     

中国2014年2~29岁人群甲型肝炎疫苗接种率及甲型肝炎报告发病分析

目的 评价中国2～29岁人群甲型肝炎（甲肝）疫苗接种率和甲肝报告发病率。方法 基于2014年全国乙型肝炎血清流行病学调查数据库中甲肝疫苗接种史信息,运用SAS 9.4软件分析2～29岁人群甲肝疫苗接种率。通过全国传染病报告信息管理系统获取2004-2014年甲肝报告发病资料,运用Excel 2007软件分析甲肝报告发病率。结果 共分析全国2～29岁人群29 058人,甲肝疫苗接种率为44.6%,年龄越小,甲肝疫苗接种率越高,其中2～6岁、7～14岁人群甲肝疫苗接种率分别为91.2%、76.0%。2004-2014年全国甲肝报告发病率逐年下降,其中2～6岁、7～14岁人群和全人群2007-2013年甲肝报告发病率下降幅度分别为82.5%、90.6%、72.1%。结论 甲肝疫苗纳入我国扩大免疫规划以后,2～6岁出生人群甲肝疫苗接种率达到90%以上,无城乡差异;2～6岁甲肝报告发病率下降幅度大于全人群。     

Hepatitis B vaccination for injection drug users--Pierce County, Washington, 2000

Hepatitis B vaccination has been recommended for injection drug users (IDUs) since 1982, but vaccination coverage of IDUs remains low (1), and outbreaks of hepatitis B among IDUs continue to occur. An outbreak of hepatitis B primarily among IDUs in Pierce County, Washington, detected in April 2000, included 60 cases and resulted in three deaths among IDUs co-infected with hepatitis delta virus. A program to administer hepatitis B vaccine to IDUs was implemented to control the outbreak, and the number of cases identified decreased from 13 per month in May to two cases since November. This report describes a vaccination program during which IDUs accepted hepatitis B vaccination provided free of charge in community-based settings and illustrates how effective hepatitis B vaccination programs targeted at IDUs can be implemented through collaborations between departments of health and corrections and community organizations.