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Control of hepatitis A by universal vaccination of adolescents, Puglia, Italy.

Lopalco PL, Prato R, Chironna M, Germinario C, Quarto M - Emerging Infect. Dis. (2008)

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Person-to-person transmission has been recognized as a major factor in spread of this disease during this period... Safe and highly effective hepatitis A vaccines have been available since 1995... In 1998, after a large epidemic of hepatitis A, a vaccination program for toddlers and adolescents was initiated in Puglia in southeastern Italy, which has a population >4 million... Until 2002, a combined hepatitis A plus B vaccine had been used for vaccination of adolescents as part of the national hepatitis B immunization program... In the same period in other regions of Italy, incidence of hepatitis A was 5 cases/100,000, without any evident annual peak... Since 2002, annual incidence rates in Puglia have remained at <2.8 cases/100,000, lower than those in the rest of Italy... Hepatitis A has been a serious public health problem in Puglia... This disease has had a detrimental effect on the local economy, which is based on tourism and trade of food products... However, since the vaccination program was started in 1998, disease incidence has decreased... During the study period, no other alternative prevention measures that could have had an effect on disease control were implemented... On the basis of available data, we cannot assess whether the current low incidence of hepatitis A in Puglia is caused by vaccination alone or in combination with other factors... Our results indicate that local health authorities should be aware of possible increases in the incidence of hepatitis A in Puglia... An urgent catch-up vaccination program may be necessary to prevent future outbreaks... Moreover, a seroepidemiologic survey would be useful for assessing the size of the susceptible population and most vulnerable age groups.

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Incidence of hepatitis A in Puglia, Italy (gray line) compared with the rest of Italy (black line), 1998–2006, and hepatitis A vaccination coverage among adolescents in Puglia (dashed line), 1998–2005.
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Figure 1: Incidence of hepatitis A in Puglia, Italy (gray line) compared with the rest of Italy (black line), 1998–2006, and hepatitis A vaccination coverage among adolescents in Puglia (dashed line), 1998–2005.

Mentions: We analyzed disease surveillance and vaccine coverage data for 1991–2006 to evaluate the effect of such a vaccination program on hepatitis A incidence in persons in Puglia during the 9 years after initiation of the program. In the period before the vaccination program was initiated (1989–1997), annual incidence rates of hepatitis A in Puglia ranged from 4.3 to 139.8 cases/100,000. The average annual rate during this period was 49.5 cases/100,000. Two large outbreaks were reported in Puglia, the first in 1992 and the second in 1996–1997 (5). During the 9 years after start of the vaccination program (1998–2006), incidence of hepatitis A decreased from 22.8 cases/100,000 in 1998 to 0.7 cases/100,000 in 2006 (Figure). In the same period in other regions of Italy, incidence of hepatitis A was 5 cases/100,000, without any evident annual peak.


Control of hepatitis A by universal vaccination of adolescents, Puglia, Italy.

Lopalco PL, Prato R, Chironna M, Germinario C, Quarto M - Emerging Infect. Dis. (2008)

Incidence of hepatitis A in Puglia, Italy (gray line) compared with the rest of Italy (black line), 1998–2006, and hepatitis A vaccination coverage among adolescents in Puglia (dashed line), 1998–2005.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2570847&req=5

Figure 1: Incidence of hepatitis A in Puglia, Italy (gray line) compared with the rest of Italy (black line), 1998–2006, and hepatitis A vaccination coverage among adolescents in Puglia (dashed line), 1998–2005.
Mentions: We analyzed disease surveillance and vaccine coverage data for 1991–2006 to evaluate the effect of such a vaccination program on hepatitis A incidence in persons in Puglia during the 9 years after initiation of the program. In the period before the vaccination program was initiated (1989–1997), annual incidence rates of hepatitis A in Puglia ranged from 4.3 to 139.8 cases/100,000. The average annual rate during this period was 49.5 cases/100,000. Two large outbreaks were reported in Puglia, the first in 1992 and the second in 1996–1997 (5). During the 9 years after start of the vaccination program (1998–2006), incidence of hepatitis A decreased from 22.8 cases/100,000 in 1998 to 0.7 cases/100,000 in 2006 (Figure). In the same period in other regions of Italy, incidence of hepatitis A was 5 cases/100,000, without any evident annual peak.

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Person-to-person transmission has been recognized as a major factor in spread of this disease during this period... Safe and highly effective hepatitis A vaccines have been available since 1995... In 1998, after a large epidemic of hepatitis A, a vaccination program for toddlers and adolescents was initiated in Puglia in southeastern Italy, which has a population >4 million... Until 2002, a combined hepatitis A plus B vaccine had been used for vaccination of adolescents as part of the national hepatitis B immunization program... In the same period in other regions of Italy, incidence of hepatitis A was 5 cases/100,000, without any evident annual peak... Since 2002, annual incidence rates in Puglia have remained at <2.8 cases/100,000, lower than those in the rest of Italy... Hepatitis A has been a serious public health problem in Puglia... This disease has had a detrimental effect on the local economy, which is based on tourism and trade of food products... However, since the vaccination program was started in 1998, disease incidence has decreased... During the study period, no other alternative prevention measures that could have had an effect on disease control were implemented... On the basis of available data, we cannot assess whether the current low incidence of hepatitis A in Puglia is caused by vaccination alone or in combination with other factors... Our results indicate that local health authorities should be aware of possible increases in the incidence of hepatitis A in Puglia... An urgent catch-up vaccination program may be necessary to prevent future outbreaks... Moreover, a seroepidemiologic survey would be useful for assessing the size of the susceptible population and most vulnerable age groups.

Show MeSH
Related in: MedlinePlus