title: Age-specific antibody prevalence to hepatitis A in England: implications for disease control.
abstract: Sera from an age-stratified sample of 7196 individuals, submitted for diagnostic purposes to four public health laboratories in England in 1986/7, were tested for hepatitis A antibody. The serological profiles, which showed marked regional differences, were consistent with declining incidence in the past. The decline in the incidence of hepatitis A has resulted in an increase in susceptibility in adults. This has three main consequences: an increase in the average age of infection may be leading to an increase in morbidity; normal immunoglobulin may become less protective against hepatitis A; the risk of transmission through blood products contaminated by viraemic blood donors may rise. Current average annual incidence in 5-14-year olds was estimated to vary between regions from 0.5-1.9%. This supports the view that, in the absence of a vaccination programme, hepatitis A will remain endemic unless there are further improvements in living conditions and standards of hygiene. A vaccine giving long-lasting protection could eliminate hepatitis A transmission with modest coverage at a young age. Targeting childhood vaccination on economically deprived areas or using vaccine to control outbreaks might be more effective policies.
authors.affiliation: Immunisation Division, PHLS Communicable Disease Surveillance Centre, London.
authors.forename: N J
authors.initials: NJ
authors.lastname: Gay
authors.forename: P
authors.initials: P
authors.lastname: Morgan-Capner
authors.forename: J
authors.initials: J
authors.lastname: Wright
authors.forename: C P
authors.initials: CP
authors.lastname: Farrington
authors.forename: E
authors.initials: E
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D035922:Hepatitis A Antibodies; D022362:Hepatitis A Vaccines; D006508:Hepatitis Antibodies / Q000097:blood*; D006507:Hepatovirus / Q000276:immunology*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D015995:Prevalence; D014761:Viral Hepatitis Vaccines
chemical_list: D035922:Hepatitis A Antibodies; D022362:Hepatitis A Vaccines; D006508:Hepatitis Antibodies; D014761:Viral Hepatitis Vaccines