[Differences in the incidence of viral hepatitis A and E in the Czech Republic]. / Odlisnosti výskytu virových hepatitid A a E v Ceské republice.

Although both viral hepatitis A (VHA) and E (VHE) are typically acquired by fecal-oral transmission, they differ in the incidence, particularly in the age-specific incidence, with VHA being reported most often in pre-school age and school age children but also in young adults while VHE often occurs in adults. VHA is common in persons from socially weak communities. Higher incidence has been reported in autumn months as a result of infection acquired during the holidays. VHE is typically acquired in cold months of the year and VHE cases are often associated with home slaughtering. To prevent both types of hepatitis it is necessary to drink safe water and to adhere to rules of personal and operational safety while preparing food. The prevention of VHA consists in active immunization, while that of VHE requires primarily that pork meat and offal should be heat processed and cross contamination between raw materials and final products should be avoided. For both types of hepatitis, epidemiological history and adequate diagnosis are prerequisites for the adoption of effective antiepidemic measures.

[Outbreaks of viral hepatitis E in the Czech Republic?]. / Epidemie virové hepatitidy E v Ceské republice?

Until recently, viral hepatitis E (VHE) has typically been an imported infection, related to travel to developing countries. A number of travel-unrelated VHE cases currently diagnosed in the Czech Republic. Outcomes of the epidemiological investigations of two VHE outbreaks associated with the consumption of pork and pork products at pig-slaughtering feasts are presented. Thirteen cases have been reported in the first outbreak and eight cases in the second outbreak. The epidemiological investigations are described and the experience gained in analysing suspected biological specimens is presented. The source of infection has not been identified in the first outbreak while in the other one, a link between human cases and infection in farm pigs was revealed for the first time. Although the epidemiological investigation may not always lead to the detection of the VHE source, it must be conducted in any outbreak and can only be successful when done in cooperation of the public health authorities with the veterinary health agency.

Vaccination of patients with diabetes mellitus--a retrospective study.

402 subjects with diabetes mellitus have been vaccinated of the total of 34,000 vaccinees immunized during the study period of 9 and half months. Altogether 229 diabetic patients (56.97%) have been vaccinated'against tick-borne encephalitis (TBE) and 74 (18.4%) against viral hepatitis (41 types A+B, 30 type A, 3 type B). The average age in four most commonly administered vaccines (FSME IMMUN 0.5 ML, Twinrix Adult, Typhim Vi, and Havrix 1440) was 65, 52, 56, and 54 years, respectively. Live attenuated vaccines have been given to 6 patients with diabetes (1.49%)--- 5 travellers to endemic countries received the yellow fever vaccine Stamaril (1 female, 4 male) and one male patient varicella vaccine Varilrix. Among the least common vaccines in diabetic patients were those against invasive pneumococcal and meningococcal infections. Not a single unexpected side effect has been observed following the vaccination procedure in any diabetic patient. Based on the results of this retrospective study we can conclude that vaccination in diabetic patients is free of any ri-k- provided that there are no other contraindications, e.g. allergy to vaccine components or severe acute febrile illness. In the case of unstable glycaemia and significantly impaired immune system due to diabetes mellitus, vaccination with live attenuated vaccines should be carefully considered and measured against the risks of exposure to each and every specific infectious agent. There is no reason to be afraid of vaccination in diabetic patients provided that general contraindications are respected. On the contrary, this risk group can benefit from vaccination more remarkably since it may have some life-saving potential.