title: An outbreak of hepatitis A in Gloucester, UK.
abstract: During an outbreak of hepatitis A that occurred in Gloucester, UK between September 1989 and January 1991, 162 clinical cases were identified through notifications and laboratory reports, a monthly attack rate of 1.05 per 10,000 residents. The highest attack rate was seen in 5-14-year-olds. There were significant correlations between hepatitis A attack rates in the electoral wards of Gloucester and with the Jarman UPA 8 scores for the wards and with overcrowding, unemployment, under 5-year-olds and ethnic minority. The use of human normal immune globulin prophylaxis (HNIG) for household contacts was unsuccessful in ending the outbreak, partly because only one third of cases reported a household contact with recent hepatitis A. Our experience does not support the use of HNIG in stopping community-wide outbreaks of hepatitis A. Two public health campaigns were mounted during the outbreak; both were followed by a fall in the number of cases. Greater priority should be given to the implementation and evaluation of public health campaigns in future community-wide outbreaks of hepatitis A.
authors.affiliation: Department of Public Health Medicine, Gloucestershire Health Authority, Montpellier.
authors.forename: F A
authors.initials: FA
authors.lastname: Majeed
authors.forename: J M
authors.initials: JM
authors.lastname: Stuart
authors.forename: K A
authors.initials: KA
authors.lastname: Cartwright
authors.forename: R
authors.initials: R
authors.lastname: Room
authors.forename: J R
authors.initials: JR
authors.lastname: Gilkes
authors.forename: M C
authors.initials: MC
authors.lastname: Smith
authors.forename: B E
authors.initials: BE
authors.lastname: Watson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003441:Crowding; D004196:Disease Outbreaks; D005190:Family; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007223:Infant; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012621:Seasons; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D016756:Immunoglobulins, Intravenous