RESUMEN
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)