title: Hepatitis A vaccination--a prison-based solution for a community-based outbreak?
abstract: 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.
authors.affiliation: Prison Surveillance Unit, Communicable Disease Surveillance Centre, Health Protection Agency Centre for Infections, 61 Colindale Avenue, London NW9 5EQ. ruth.gilbert@hpa.org.uk
authors.forename: R L
authors.initials: RL
authors.lastname: Gilbert
authors.forename: T
authors.initials: T
authors.lastname: O'Connor
authors.forename: S
authors.initials: S
authors.lastname: Mathew
authors.forename: K
authors.initials: K
authors.lastname: Allen
authors.forename: M
authors.initials: M
authors.lastname: Piper
authors.forename: O N
authors.initials: ON
authors.lastname: Gill
mesh_terms: 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