Much gained by integrating contact tracing and vaccination in the hepatitis B antenatal screening program in Amsterdam, 1992-1999.
OBJECTIVE
Hepatitis B control in Europe concentrates on antenatal screening to reduce vertical transmission. To reduce horizontal transmission and the pool of infectious individuals, the Municipal Health Service of Amsterdam integrated tracing and immunising of contacts in the antenatal screening program.


METHODS
An eight year (1992-1999) descriptive study of this public health program, where contacts are tested for serological markers of previous infection, and vaccination is offered to susceptible contacts. Chronically infected contacts are counselled and referred for treatment if justified.


RESULTS
For 738 newly identified women testing positive for the hepatitis B surface antigen, 1219 contacts were reported; 1100 (90.4%) contacts participated, 476 (43%) had serological markers of previous infection, of whom 119 (25%) were infectious. Of 603 eligible contacts, 568 (94%) completed the vaccination series. Country of origin was an independent predictor of contact participation and compliance with completion of the vaccination series. Postvaccination titres for antibodies against the surface antigen were below 10 IU/L in 4.5% of contacts under 30, in 12.2% of those over 30.


CONCLUSIONS
Tracing and immunising susceptible contacts of women screened as HBsAg-positive, should be an integral component of any country's HBV control program.
van Steenbergen
Jim E
JE
GG&GD (Municipal Health Service), Department of Infectious Diseases, P.O. Box 2200, 1000 CE Amsterdam, The Netherlands. jvansteenbergen.lci@ggd.nl
Baayen
Dorothé
D
Peerbooms
Paul G H
PG
Coutinho
Roel A
RA
Van Den Hoek
Anneke
A
D016358:Contact Tracing / Q000706:statistics & numerical data*; D005260:Female; D006509:Hepatitis B / Q000276:immunology* / Q000517:prevention & control; D017325:Hepatitis B Vaccines; D006801:Humans; D007231:Infant, Newborn; D008403:Mass Screening / Q000706:statistics & numerical data*; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D018570:Risk Assessment
D017325:Hepatitis B Vaccines