Hepatitis A vaccination--a prison-based solution for a community-based outbreak?
In December 2001, an increase in cases of hepatitis A was observed in South Yorkshire. Cases were predominantly young males who reported injecting drug use. A community-based vaccination programme was introduced in November 2002, but new cases continued to occur. In March 2003, a vaccination campaign was implemented in the local prison for a four-week period. One thousand two hundred and thirty-six (91%) prisoners were vaccinated. Two thirds (895/1,363) of the prisoners came from the area affected by the outbreak and 52% (465/895) reported injecting drugs. The median age of injectors was 25 years. Notifications of cases of hepatitis A from South Yorkshire ceased in August 2003. Although on this occasion the prison vaccination campaign was probably implemented too late to have had a significant impact on the local outbreak, a large number of young male injectors from the local area were successfully vaccinated. This suggests that a prison-based intervention offers a potentially effective way of immunising the IDU population and interrupting a community-based outbreak.
Gilbert
R L
RL
Prison Surveillance Unit, Communicable Disease Surveillance Centre, Health Protection Agency Centre for Infections, 61 Colindale Avenue, London NW9 5EQ. ruth.gilbert@hpa.org.uk
O'Connor
T
T
Mathew
S
S
Allen
K
K
Piper
M
M
Gill
O N
ON
D000293:Adolescent; D000328:Adult; D000368:Aged; D004196:Disease Outbreaks / Q000517:prevention & control*; D006506:Hepatitis A / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D017589:Immunization Programs / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011329:Prisoners; D015397:Program Evaluation; D015819:Substance Abuse, Intravenous / Q000821:virology*; D006113:United Kingdom / Q000453:epidemiology