Screening family and sexual contacts of HBsAg+ persons in the Pilsen region.

THE AIM OF THE STUDY: To detect HBsAg-positive persons and to offer their family and sexual contacts, after screening for viral hepatitis B (VHB) markers, free vaccination against the infection. MATERIAL AND METHODS: In collaboration with laboratories, all persons with confirmed HBsAg in the Pilsen Region (549,618 population) were prospectively detected. From these persons, the following data were collected: reason for examination, clinical diagnosis, and ethnicity/nationality. Their family and sexual contacts were screened for serologic markers (HBsAg, anti-HBc, anti-HBs) and vaccinated. RESULTS: Between 1997-2005, 1,053 HBsAg+ persons were routinely detected by the laboratories in the Pilsen Region. The average age of the infected persons was 41.7 years (range 0-90 years). At the time of the detection, 63.4% of the HBsAg positives were clinically "healthy" carriers. Within the monitored period there was a considerable increase in the HBsAg positivity rate among immigrants (particularly from Vietnam). Of 908 family and sexual contacts, 18% were positive for hepatitis B markers. The highest seropositivity rates (33.9% and 27.7%) were found in siblings and parents, respectively, of the HBsAg+ persons. So far 77.5% of the susceptible contacts have used the opportunity for free vaccination. CONCLUSION: The study has proven the importance of detecting HBsAg carriers and vaccinating their contacts. Special attention should be paid to immigrant families, particularly from Asia. Consistent vaccination of family and sexual contacts of HBsAg+ persons can contribute to a more rapid elimination of hepatitis B in the Czech Republic.

The prevalence of tick-borne encephalitis in the region of West Bohemia (Czech Republic) between 1960-2005.

Between 1960-2005, 1,621 cases of tick-borne encephalitis were confirmed by laboratory testing in the region of West Bohemia (now the regions of Pilsen and Karlovy Vary) which represents a rate of infection of 4.1 per 100,000 inhabitants per year. The highest infection rate was established in men aged 20-24 and women aged 45-54. Over the monitored years, there was a significant shift of the maximum infection rate into an older age group. Currently, it is the 45-64 age group which carries the highest rate of infection. Of the identified disease cases, 12 were lethal, which represents 0.7% of the total. Over the years, the risks of transmission in particular areas of the region have changed. The highest infection rate is currently in the district of Klatovy (21.7 per 100,000 inhabitants per year). Of the total number, only two cases were contracted outside the Czech Republic (Slovakia and Austria). In 4.8% cases, the patient's anamnesis showed data on the consumption of non-pasteurized milk. 3.0% of infections probably originated as a result of professional exposure. Over the years, the season of infection has extended. Presently, the transmission can occur anytime between March and November. According to official data, only 6.7% of the population in the Pilsen district has been vaccinated so far. The low percentage of vaccinated cases may, however, in no way influence the unfavorable epidemiological situation regarding tick-borne encephalitis.