The diverse patterns of hepatitis A epidemiology in the United States-implications for vaccination strategies.
Hepatitis A is the most frequently reported vaccine-preventable disease in the United States. Hepatitis A incidence and risk factors during 1983-1995 were examined among cases reported to the study's Sentinel Counties: Denver County, Colorado; Pierce County, Washington; Jefferson County, Alabama; and Pinellas County, Florida. Of 4897 serologically confirmed cases, 611 patients (13%) were hospitalized and 9 (0.2%) died. The average incidence was 14.7/100, 000 (range, 0.6-100.7/100,000, depending on county and year). The frequency of reported sources of infection varied by county, but the largest single group overall (52%) did not report a source. During 3-year communitywide outbreaks in Denver (1991-1993) and Pierce (1987-1989) Counties, rates increased 4- and 13-fold, respectively, and increased in all age, racial/ethnic, and risk groups. During communitywide outbreaks, hepatitis A is not limited to specific risk groups; sustained nationwide reductions in incidence are more likely to result from routine childhood vaccination than from targeted vaccination of high-risk groups.
Bell
B P
BP
Centers for Disease Control and Prevention, Atlanta, Georgia, 30333, USA.
Shapiro
C N
CN
Alter
M J
MJ
Moyer
L A
LA
Judson
F N
FN
Mottram
K
K
Fleenor
M
M
Ryder
P L
PL
Margolis
H S
HS
D000293:Adolescent; D000328:Adult; D000407:Alabama / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D005431:Florida / Q000453:epidemiology; D006506:Hepatitis A / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D022362:Hepatitis A Vaccines; D017957:Hepatitis A Virus, Human / Q000276:immunology; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000379:methods; D014761:Viral Hepatitis Vaccines; D014861:Washington / Q000453:epidemiology
D022362:Hepatitis A Vaccines; D014761:Viral Hepatitis Vaccines