title: The investigation of a 'cluster' of hepatitis B in teenagers from an indigenous community in North Queensland.
abstract: BACKGROUND
  In early 1999, five teenagers from the same Indigenous community were notified as having hepatitis B. Hepatitis B vaccine should have been offered to this cohort of teenagers in a 'catch-up' program during the late 1980s when they were of pre-school age.
  
  
  OBJECTIVE
  To determine the vaccination status of residents of the community born between 1981 and 1985 (inclusive) and to ascertain the prevalence of markers of hepatitis B infection and carriage in the incompletely vaccinated teenagers in this cohort.
  
  
  METHODS
  Community health records were examined to identify all residents in the study cohort. Immunisation records were obtained from local hospital records and from a statewide computerised vaccination database. Serological tests for markers of hepatitis B infection and carriage were performed on blood samples from the incompletely vaccinated teenagers.
  
  
  RESULTS
  Only 44% of 235 teenagers who had their vaccination status assessed were fully vaccinated. One hundred and eleven (47%) of the cohort had not received any hepatitis B vaccine. Over 90% of the incompletely vaccinated had been infected with the hepatitis B virus and 26% of these were hepatitis B carriers.
  
  
  CONCLUSIONS
  Despite the availability of an effective hepatitis B vaccine and the recommendation for a catch-up program, the pre-school aged cohort of children at the community were not effectively targeted for vaccination. Hepatitis B remains a consequential infection in Indigenous communities in North Queensland.
  
  
  CONCLUSIONS
  Initiatives to control hepatitis B need to be enhanced within existing maternal and child health, sexual health, alcohol and drug and chronic disease management programs.
authors.affiliation: Tropical Public Health Unit, Queensland Health, Cairns, Queensland. Ruth_Fagan@health.qld.gov.au
authors.forename: R L
authors.initials: RL
authors.lastname: Malcolm
authors.forename: L
authors.initials: L
authors.lastname: Ludwick
authors.forename: D L
authors.initials: DL
authors.lastname: Brookes
authors.forename: J N
authors.initials: JN
authors.lastname: Hanna
mesh_terms: D000293:Adolescent; D015331:Cohort Studies; D004196:Disease Outbreaks; D006509:Hepatitis B / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D011793:Queensland / Q000453:epidemiology; D016036:Seroepidemiologic Studies