A prevalence study of hepatitis A virus infection in a migrant community: Is hepatitis A vaccine indicated?
BACKGROUND
The Advisory Committee on Immunization Practices recommends routine hepatitis A vaccination of children living in communities with high rates of hepatitis A. Rates among children living in migrant farm worker families are unknown.


METHODS
Participants recruited from the 1243 migrant children aged 2 to 18 years in Okeechobee County, Florida, were administered a questionnaire. A blood sample was taken for testing for antibodies to hepatitis A virus (anti-HAV), and hepatitis A vaccine was administered.


RESULTS
Of 244 (20%) participating children, 125 (51%) were anti-HAV-positive. Seropositivity increased with age from 34% (2- to 5-year-olds) to 81% (>/=14-year-olds) (P <.0001). In multivariate analysis, age (odds ratio [OR] = 1.2/year; 95% CI = 1.1 to 1.3), having a Mexican-born father (OR = 12.2; 95% CI = 2.2 to 227.9), and age on moving to the United States (OR = 1.3/year; 95% CI = 1.0 to 1.6) were independently associated with anti-HAV positivity. Among US-born children aged 2 to 5 years who had never left the United States, 33% were anti-HAV-positive.


CONCLUSIONS
Anti-HAV prevalence among migrant children in Okeechobee County, including the youngest US-born children, is high, indicating ongoing transmission of HAV. Children in this and other US migrant communities may benefit from hepatitis A vaccination.
Dentinger
C M
CM
Hepatitis Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Heinrich
N L
NL
Bell
B P
BP
Fox
L M
LM
Katz
D J
DJ
Culver
D H
DH
Shapiro
C N
CN
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004641:Emigration and Immigration; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology* / Q000517:prevention & control; D022362:Hepatitis A Vaccines / Q000627:therapeutic use; D006801:Humans; D016015:Logistic Models; D008297:Male; D008800:Mexico / Q000208:ethnology; D015999:Multivariate Analysis; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D022362:Hepatitis A Vaccines