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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.
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Summary

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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

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