Hostname: page-component-5c6d5d7d68-tdptf Total loading time: 0 Render date: 2024-08-27T15:19:55.591Z Has data issue: false hasContentIssue false
  • English
  • Français

Age-specific antibody prevalence to hepatitis A in England: implications for disease control

Published online by Cambridge University Press:  15 May 2009

N. J. Gay ,
P. Morgan-Capner ,
J. Wright ,
C. P. Farrington  and
E. Miller
N. J. Gay
Affiliation:
Immunisation Division, PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ
P. Morgan-Capner
Affiliation:
Preston Public Health Laboratory, Royal Preston Hospital, PO Box 202, Sharoe Green Lane, Preston PR2 4HG
J. Wright
Affiliation:
Preston Public Health Laboratory, Royal Preston Hospital, PO Box 202, Sharoe Green Lane, Preston PR2 4HG
C. P. Farrington
Affiliation:
Immunisation Division, PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ
E. Miller*
Affiliation:
Immunisation Division, PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ
*
* Author for correspondence and reprints.
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Sera from an age-stratified sample of 7196 individuals, submitted for diagnostic purposes to four public health laboratories in England in 1986/7, were tested for hepatitis A antibody. The serological profiles, which showed marked regional differences, were consistent with declining incidence in the past. The decline in the incidence of hepatitis A has resulted in an increase in susceptibility in adults. This has three main consequences: an increase in the average age of infection may be leading to an increase in morbidity; normal immunoglobulin may become less protective against hepatitis A; the risk of transmission through blood products contaminated by viraemic blood donors may rise.

Current average annual incidence in 5–14-year olds was estimated to vary between regions from 0·5–1·9%. This supports the view that, in the absence of a vaccination programme, hepatitis A will remain endemic unless there are further improvements in living conditions and standards of hygiene. A vaccine giving long-lasting protection could eliminate hepatitis A transmission with modest coverage at a young age. Targeting childhood vaccination on economically deprived areas or using vaccine to control outbreaks might be more effective policies.

Type
Research Article
Information
Epidemiology & Infection , Volume 113 , Issue 1 , August 1994 , pp. 113 - 120
Copyright
Copyright © Cambridge University Press 1994

References

REFERENCES

1.Maguire, H, Heptonstall, J, Begg, NT. The epidemiology and control of hepatitis A. Commun Dis Rep 1992; 2: R114–117.Google ScholarPubMed
2.Breen, D, Ramsay, C, Walker, S. Hepatitis A in Edinburgh 1987–88. Comm Dis Scotland 1988; 88/45: 6–11.Google Scholar
3.Regan, M, Syed, Q, Corkery, A. Hepatitis A vaccine. BMJ 1991; 303: 414.Google Scholar
4.Report to the Director of the Public Health Laboratory Service. Assessment of British gammaglobulin in preventing infectious hepatitis. BMJ 1968; 3: 451–4.CrossRefGoogle Scholar
5.Majeed, FA, Stuart, JM, Cartwright, KAV. An outbreak of hepatitis A in Gloucester, UK. Epidemiol Infect 1992; 109: 167–73.Google Scholar
6.Siegl, G, Lemon, SM. Recent advances in hepatitis A vaccine development. Virus Res 1990; 17: 75–92.Google Scholar
7.Parry, JV. Hepatitis A infection: guidelines for development of satisfactory assays for laboratory diagnosis. Med Lab Sci 1981; 38: 303–11.Google ScholarPubMed
8.McCullagh, P, Nelder, JA. Generalised linear modelling. 2nd ed.London: Chapman and Hall. 1989.Google Scholar
9.Anderson, RM, May, RM. Infectious disease of humans: dynamics and control. Oxford: Oxford University Press, 1991.Google Scholar
10.Office of Population Censuses and Surveys. Key population and vital statistics. Series VS no. 13, PP1 no. 9. London: HMSO, 1986.Google Scholar
11.Tilzey, AJ, Banatvala, JE. Hepatitis A: Changing prevalence and possible vaccines. BMJ 1991; 302: 1552–3.CrossRefGoogle Scholar
12.Schenzle, D, Dietz, K, Frosner, GG. Antibody against hepatitis A in seven European countries. II. Statistical analysis of cross-sectional surveys. Am J Epidemiol 1979; 110: 70–6.Google Scholar
13.Frosner, G, Willers, H, Muller, R, Schenzle, D, Deinhardt, F, Hopken, W. Decrease in incidence of hepatitis A infections in Germany. Infection 1978; 6: 259–60.CrossRefGoogle ScholarPubMed
14.Higgins, G, Wreghitt, TG, Gray, JJ, Blagdon, J, Taylor, CED. Hepatitis A virus antibody in East Anglian blood donors. Lancet 1990; 336: 1330.Google Scholar
15.Mannici, PM, for the Medical Scientific Committee, Fondazione dell ′Emofilia. Outbreak of hepatitis A among Italian patients with haemophilia. Lancet 1992; 339: 819.CrossRefGoogle Scholar
16.Gerrizen, A, Schneweis, KE, Brackmann, H-H et al. , Acute hepatitis A in haemophiliacs. Lancet 1992; 340: 1231–2.Google Scholar
17.Temperley, IJ, Cotter, KP, Walsh, TJ, Power, J, Hillary, IB. Clotting factors and hepatitis A. Lancet 1992; 340: 1466.Google ScholarPubMed
18.Peerlinck, K, Vermylen, J. Acute hepatitis A in patients with haemophilia A. Lancet 1993: 341: 179.CrossRefGoogle ScholarPubMed
19.Krugman, S, Ward, R, Giles, JP, Bodansky, O, Jacobs, AM. Infectious hepatitis: detection of virus during the incubation period in clinically inapparent infection. N Engl J Med 1959; 261: 729–34.Google Scholar
20.Communicable Disease Surveillance Centre. Viral hepatitis, England and Wales: laboratory reports, weeks 93/16–19. Commun Dis Rep 1993; 3: 94.Google Scholar