title: The increasing prominence of household transmission of hepatitis A in an area undergoing a shift in endemicity.
abstract: In the rapidly developing city of Almaty, Kazakhstan, rates of hepatitis A have fallen, but no data on prevalence of antibody to hepatitis A virus (anti-HAV) exist with which to interpret incidence data. In the autumn of 2001, we determined the anti-HAV prevalence among household and school contacts of hepatitis A cases. For contacts aged 0-4 years, 5-9 years, 10-14 years, 15-19 years, or 20-30 years, immune prevalences were 9, 12, 33, 33 and 77% respectively, among immediate-family household contacts and 15, 28, 49, 52 and 77% respectively, among community contacts. Child community contacts were more likely to be immune than their immediate-family household counterparts (odds ratio 2.0, 95% confidence interval 1.3-3.2). Almaty is experiencing an epidemiological shift in hepatitis A incidence. Feasible and effective prevention strategies using hepatitis A vaccine should be explored.
authors.affiliation: Department of Epidemiology, School of Public Health, The University of Michigan, Ann Arbor, MI 48109, USA. jvictor@umich.edu
authors.forename: J C
authors.initials: JC
authors.lastname: Victor
authors.forename: T Y
authors.initials: TY
authors.lastname: Surdina
authors.forename: S Z
authors.initials: SZ
authors.lastname: Suleimeova
authors.forename: M O
authors.initials: MO
authors.lastname: Favorov
authors.forename: B P
authors.initials: BP
authors.lastname: Bell
authors.forename: A S
authors.initials: AS
authors.lastname: Monto
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005190:Family; D005260:Female; D006506:Hepatitis A / Q000517:prevention & control / Q000635:transmission*; D022362:Hepatitis A Vaccines / Q000276:immunology; D006801:Humans; D007223:Infant; D007623:Kazakhstan / Q000453:epidemiology; D008297:Male; D016036:Seroepidemiologic Studies; D014611:Vaccination
chemical_list: D022362:Hepatitis A Vaccines