Vaccination against hepatitis A during outbreaks starting in schools: what can we learn from experiences in central Italy?
Two outbreaks of hepatitis A started almost simultaneously in a maternal school and in a day care centre located at opposite sides of Florence, Italy, at the end of 2002. Both of them originated from immigrant children, and in both cases, hepatitis A was initially not recognised due to aspecific symptoms. While vaccination of contacts started with delay in the first outbreak, the same intervention was organised and performed in 3 days in the other. The outbreak starting in the maternal school caused 30 notified cases, plus 7 cases diagnosed retrospectively. Nine of them were in a secondary school, where vaccination (in accordance with the Italian national guidelines on hepatitis A (HA) vaccination) had been started only after a secondary case occurred. Only three cases occurred overall in the other outbreak starting in the day care centre, where >80% of infants, children and personnel were immunised. Although few asymptomatic infections probably occurred, no source of contagion existed any longer 2 months after immunisation. A rapid vaccination of school and family contacts of hepatitis A cases after the first case (irrespective of school grade) seems to play an important role to shorten outbreak duration.
Bonanni
Paolo
P
Public Health Department, University of Florence, Viale G.B. Morgagni 48-50134 Florence, Italy. paolo.bonanni@unifi.it
Franzin
Anita
A
Staderini
Chiara
C
Pitta
Maria
M
Garofalo
Giorgio
G
Cecconi
Rossella
R
Santini
Maria Grazia
MG
Lai
Piero
P
Innocenti
Barbara
B
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks / Q000517:prevention & control*; D005260:Female; D006506:Hepatitis A / Q000453:epidemiology* / Q000517:prevention & control*; D022362:Hepatitis A Vaccines / Q000494:pharmacology*; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D012574:Schools; D013997:Time Factors
D022362:Hepatitis A Vaccines