Study of the epidemiology of hepatitis A virus infection in the Jamaican population

Hepatitis A virus (HAV), is an RNA virus in the picornavirus family. It is transmitted faecal-orally by contaminated food or drink. It has a worldwide distribution, and like other enteric infectious diseases it is typically an infection of childhood, related to conditions of crowding and poor hygiene. HAV causes only acute hepatitis and has never been associated with chronic liver disease such as seen with hepatitis B virus or hepatitis C virus. Infections with HAV may be prevented by improving levels of sanitation and hygiene and immunization with HAV vaccine. Between January 1995 and August 1998, 339 individuals were recruited into the study of epidemiology of HAV. Sera from the participants were tested for anti-HAV IgG using the Enzyme Linked Immunosorbent Assay (ELISA) technique (Abbott Laboratories, Abbott Park IL 60064). Social and demographic data were collected using questionnaires. The age of the participants ranged from 3-90 years. There were 128 males and 211 females. The average of males and females was 25 years. The seroprevalence of HAV in the population using ELISA was 59.9 percent. Age and source of water supply were found to be the major contributors to exposure to HAV. The seroprevalence of HAV in Jamaica is higher than that seen generally in developed countries, although the age related acquisition was similar. Improved water supply, educating the public on the epidemiology of HAV and immunization in the preschool age children could reduce the prevalence of HAV in Jamaica (AU)

Hepatitis A among health workers in Paris hospitals. Occupational Health Physicians of Paris Hospital (AP-HP)

To design a vaccination strategy against hepatitis A among hospital employees, we carried out a serological survey against hepatitis A virus (HAV) infection in 10 university hospitals in the Paris area. Subjects under 60 years of age were consecutively enrolled by occupational health services and tested for IgG to HAV by ELISA. Of the 1,516 subjects recruited, 926 were health workers (HW), 322 clerks, and 268 cooks or kitchen employees. Among HW and clerks the HAV seroprevalence was 53.8 percent (95 percent CI: 44.0-65.6), increasing with age and being higher among Europe (83.6 percent vs 45.6 percent, P < .001). Age correlated closely with the duration of hospital work, so only age was taken into account for further analysis. The HAV seroprevalences among HW and clerks originating from Europe were close (48.8 percent vs 42.6 percent) and remained so after adjustment for age. HAV seroprevalences in HW caring for adults and those caring for children were also similar (45.2 percent vs 40.1 percent). Seroprevalence was higher in assistant nurses than in nurses (51.3 percent vs 39.8 percent, P < .02). Among cooks and kitchen employees, 53.4 percent were HAV-seropositive. This study shows that hospital employees need not routinely be vaccinated against HAV; the decision should be taken by the occupational physician according to the type of work, but should be routine for cooks and kitchen employees. The need for prevaccinal screening for anti-HAV should be assessed in the light of employees' geographical origin and age.(Au)

A study of the epidemiology of hepatitis A virus infection in the Jamaican population

Hepatitis A virus (HAV), is an RNA virus in the picornavirus family. It is transmitted faecal-orally by contaminated food drink. It has a worldwide distribution, and like other enteric infectious diseases it is typically an infection of childhood, related to conditions of crowding and poor hygiene. HAV causes only acute hepatitis and has never been associated with chronic liver disease such as seen with hepatitis B virus or hepatitis C virus. Infection with HAV may be prevented by improving levels of sanitation and hygiene and immunization with HAV vaccine. Between January 1995 and August 1998, 339 individuals were recruited into the study of the epidemiology of HAV. Sera from the participants were tested for anti-HAV IgG using the Enzyme Linked Immunosorbent Assay (ELISA) technique (Abbot Laboratories, Abbort Park, IL 60064). Social and demographic data were collected using questionnaires. The age of the participants ranged from 3-90 years. There was 128 males and 211 females. The average age of males and females was 25 years. The seroprevalence of HAV in the population using ELISA was 59.9 percent. Age and source of water supply were found to be the major contributors to exposure to HAV. The seroprevalence of HAV in Jamaica is higher than the seen generally in developed countries, although the age related acquisition was similar. Improved water supply, educating the public on the epidemiology of HAV and immunization in the preschool age children could reduce the prevalence of HAV in Jamaica.(Au)

Initial report of a hepatitis investigation in rural Belize

In spring 1991, Belizian health officials expressed concern about a possible hepatitis outbreak in a banana farming district. A study was designed to identify cases and to address the serological prevalence of hepatitis virus markers. Three populations were studied: (i) persons meeting a clinical case definition for hepatitis; (ii) designated banana workers; and (iii) people in a random sample of households in the community. Information was collected using questionnaires and sera were collected for laboratory testing. This report presents the preliminary results of a study conducted in June 1991. Among people who met the clinical case definition, 24 percent of 42 tested had immunoglobulin M antibody to hepatitis B virus (HBV) core antigen (anti-HBc IgM). In the worker and household survey populations, 248 and 280 people, respectively, were tested for anti-HBc IgM. In each group, 4 percent were positive. HBV surface antigen was found in 37 percent of 43 clinical cases, 18 percent of workers, and 13 percent of people in the household survey. Among the 3 study populations, the prevalence of HBV core antibody (anti-HBc) ranged from 73 percent to 81 percent. Almost all tested persons had evidence of prior infection with hepatitis viruses A and B was widespread, but an aetiology could not be established for most of the clinical cases. However, the prevalence of hepatitis B markers in this population was very high compared to other reports from the Caribbean (AU)

The prevalence of hepatitis A and B infection among different ethnic groups in Belize - abstract

Little is known about the prevalence of infection with hepatitis viruses in Belize, Central America. We conducted a serological survey among members of the Belize Defence Force (BDF), which comprises the five major ethnic groups in Belize, in order to estimate the prevalence of hepatitis A and B among men and women of military age in Belize. Of approximately 600 men and women in the BDF, 394 (66 per cent) volunteered to participate. Antibody to hepatitis A was found in 95 per cent with similar rates by age, rank and ethnicity. Antibody to hepatitis B core antigen (anti-HBc) was found in 31 per cent. The prevalence of anti-HBc varied significantly among the ethnic groups, with the lowest rates in Mayan Indians (5 per cent) and Mestizo (7 per cent), with significantly higher rates among Creoles (30 per cent) and Garifuna (54 per cent). Rates increased with increasing age from 25 per cent in those 18 - 24 years to 35 per cent in those over 35 years of age (p = 0.6, chi-square for trend). Hepatitis B surface antigen was found in 15 (4 per cent) overall. Rates of hepatitis A and B antibodies among 70 military recruits (mean age 20 years) were similar to those among regular forces; anti-HAV was found in 91 per cent, anti-HBc in 34 per cent, and HBsAg in 6 per cent. In this young healthy population, exposure to hepatitis A before the age of 18 years is almost universal, while exposure to hepatitis B is related to age and ethnicity (AU)

An increase in the number of reported cases of Hepatitis A in the Turks & Caicos Islands

The Chief Medical Officer of the Turks & Caicos islands contacted CAREC on the afternoon of March 1st requesting assistance with the investigation of an outbreak of hepatitis. They estimated there were 17 cases between September 1992 and March 1st 1993. Six of the recent cases were confirmed as Hepatitis A by the Centers for Disease Control. A review of the cases of Hepatits as reported to CAREC over the last thirteen (13) years showed that an average of one to two cases were reported per year. The 17 cases therefore constituted an outbreak. CAREC agreed to provide assistance with the investigation and control of the outbreak (AU)

Investigation of an hepatitis A outbreak in a rural squatting community associated with a contaminated water-source in County St. George East, Trinidad - abstract

Following a report of a confirmed case of Hepatitis A in a child, a cross sectional epidemiological and an environmental survey were done on the total population ( about 90 households) of a village adjacent to the Arima river from April to September, 1989. The residents had no legal claim to the land and there was no pipe-bourne water supply or scavenging service to the area. Cases of Hepatitis A were identified based on clinical signs and symptoms, and a case control analysis was done using affected and non-affected households. Based on case definition criteria, the attack rate was 22 per cent and 30 cases were found. The age distribution was typical of Hepatitis A, and an epidemic curve had some features of both a common source and a propagated source epidemic. Highly significant were exposures related to using the river as a water source, using a spring and a household size > 4. It was concluded that there was an Hepatitis A outbreak, and the initial source was a river which collected waste from the nearby town and the effluent from a water treatment plant. This outbreak serves as a useful indicator of declining socio-economic conditions and deteriorating environmental standards (AU)